Organization Active NPI

Sbcrs Inc

  • Colon & Rectal Surgery Physician
  • Fort Lauderdale, FL
National Provider Identifier
1801089545
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
ME75795 Issued in FL
Legal business name
SBCRS INC
Practice address
904 NW 9TH Ave
Fort Lauderdale, FL 33311-7204
Phone
(954) 607-4237
Fax
(954) 779-7526
NPI assigned
Aug 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Authorized official

Name
Fabio M Potenti, M.D.
Title
C.E.O.
Phone
(954) 607-4237

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208C00000X ME75795 FL Primary

Addresses

Primary practice location

904 NW 9TH Ave
Fort Lauderdale, FL 33311-7204

Mailing address

904 NW 9TH Ave
Fort Lauderdale, FL 33311-7204
Phone (954) 607-4237

Other identifiers 1

IdentifierTypeStateIssuer
271217200MedicaidFL

Other names 1

  • SOUTH BROWARD COLON AND RECTAL SURGERY Other name

National Provider Directory

National Provider Directory

Locations

904 NW 9th Ave
Ft Lauderdale, FL 33311
Phone (954) 607-4237

4700 Sheridan St
Ste F
Hollywood, FL 33021
Phone (954) 961-8400

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1801089545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 NW 9TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333117204",
            "telephone_number": "954-607-4237",
            "fax_number": "954-779-7526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 NW 9TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333117204",
            "telephone_number": "954-607-4237",
            "fax_number": "954-779-7526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SBCRS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "POTENTI",
        "authorized_official_first_name": "FABIO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "954-607-4237",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME75795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271217200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH BROWARD COLON AND RECTAL SURGERY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.