Sacred Heart Medical Home, PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME64482 Issued in FL

Legal business name

SACRED HEART MEDICAL HOME, PA

Practice address

17901 NW 5TH St
Suite 205
Pembroke Pines, FL 33029-2810

Phone

(954) 392-0333

Fax

(954) 392-0393

NPI assigned

Jun 8, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yvelice Antonia Villaman-Bencosme

Title

President

Phone

(954) 392-0333

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841493566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17901 NW 5TH ST",
            "address_2": "SUITE 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292810",
            "telephone_number": "954-392-0333",
            "fax_number": "954-392-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17901 NW 5TH ST",
            "address_2": "SUITE 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292810",
            "telephone_number": "954-392-0333",
            "fax_number": "954-392-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED HEART MEDICAL HOME, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VILLAMAN-BENCOSME",
        "authorized_official_first_name": "YVELICE",
        "authorized_official_middle_name": "ANTONIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-392-0333"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME64482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eduardo Sabas
• Ornella Lucia Saborido Battaglia, MD
• Ayhem Sabry, DC
• Tamer Attiah Sabry, D.C.
• Christine Anne Sacramento, ATC, NREMT-B
• Sacred Heart Medical Office PA
• Bilal Sadiq, MD
• Kaywan Saed, DO
• Safe Space Wellness Services, LLC
• Sage Dental of Pembroke Pines, PLLC

• Pediatrics Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.