Lighthouse Point OB/GYN,PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME43336 Issued in FL

Legal business name

LIGHTHOUSE POINT OB/GYN,PLLC

Practice address

601 E Sample Rd
Suite 103
Pompano Beach, FL 33064-4443

Phone

(954) 781-0180

Fax

(954) 781-3230

NPI assigned

Feb 24, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Adib A Chidiac

Title

M.D.

Phone

(954) 781-0180

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1266969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267660800000",
    "number": "1780906339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E SAMPLE RD",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "330644443",
            "telephone_number": "954-781-0180",
            "fax_number": "954-781-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E SAMPLE RD",
            "address_2": "SUITE 103",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330644443",
            "telephone_number": "954-781-0180",
            "fax_number": "954-781-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE POINT OB/GYN,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-24",
        "last_updated": "2010-03-04",
        "status": "A",
        "authorized_official_last_name": "CHIDIAC",
        "authorized_official_first_name": "ADIB",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "954-781-0180"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME43336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370810100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Pompano Beach, FL
• Providers in Pompano Beach, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.