NPIMap

Organization Active NPI

Infectious Diseases Associates of Fort Lauderdale PA

  • Infectious Disease Physician
  • Ft. Lauderdale, FL
National Provider Identifier
1831255363
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
INFECTIOUS DISEASES ASSOCIATES OF FORT LAUDERDALE PA
Practice address
4750 N. Federal Highway
Suite 200
Ft. Lauderdale, FL 33308
Phone
(954) 772-7773
Fax
(954) 772-2221
NPI assigned
Dec 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Authorized official

Name
Dr. Stephen A Renae, M.D.NPI 1841296670
Title
Physician - President/Owner
Phone
(954) 772-7773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

4750 N. Federal Highway
Suite 200
Ft. Lauderdale, FL 33308

Mailing address

4750 N. Federal Highway
Suite 200
Ft. Lauderdale, FL 33308
Phone (954) 772-7773

Other identifiers 1

IdentifierTypeStateIssuer
255060100MedicaidFL

National Provider Directory

National Provider Directory

Locations

4750 N Federal Hwy
Ste 200
Ft Lauderdale, FL 33308
Phone (954) 561-3338

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283212800000",
    "number": "1831255363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 N. FEDERAL HIGHWAY",
            "address_2": "SUITE 200",
            "city": "FT. LAUDERDALE",
            "state": "FL",
            "postal_code": "33308",
            "telephone_number": "954-772-7773",
            "fax_number": "954-772-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 N. FEDERAL HIGHWAY",
            "address_2": "SUITE 200",
            "city": "FT. LAUDERDALE",
            "state": "FL",
            "postal_code": "33308",
            "telephone_number": "954-772-7773",
            "fax_number": "954-772-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASES ASSOCIATES OF FORT LAUDERDALE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2010-08-31",
        "status": "A",
        "authorized_official_last_name": "RENAE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN - PRESIDENT/OWNER",
        "authorized_official_telephone_number": "954-772-7773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255060100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft. Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.