Awaken Health Direct Primary Care, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

AWAKEN HEALTH DIRECT PRIMARY CARE, PLLC

Practice address

12525 Orange Dr Ste 710
Davie, FL 33330-4308

Phone

(954) 646-6911

NPI assigned

Oct 3, 2023

Organization subpart

No

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

Authorized official

Name

Florencia Goluboff, MDNPI 1437788718

Title

Owner

Phone

(954) 646-6911

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Florencia Goluboff, MD

  • Family Medicine Physician
  • Davie, FL
  • NPI 1437788718
  NPD Authorized official

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1801676267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12525 ORANGE DR STE 710",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333304308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12525 ORANGE DR STE 710",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333304308",
            "telephone_number": "954-646-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAKEN HEALTH DIRECT PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "GOLUBOFF",
        "authorized_official_first_name": "FLORENCIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-646-6911",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ileana Ayala
• Saleem Azad, D.O.
• Tariq Azeez, OTA

• Primary Care Clinic/Center in Davie, FL
• Providers in Davie, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.