Broward Dermatology

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

OS9463 Issued in FL

Legal business name

BROWARD DERMATOLOGY

Practice address

500 SE 15TH St
Suite #108
Fort Lauderdale, FL 33316-1952

Phone

(954) 990-6591

NPI assigned

Jul 6, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jerome Obed, D.O.NPI 1720055585

Title

Medical Director

Phone

(954) 990-6591

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Broward Dermatology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jerome R Obed D.O.,P.a.

  dba Broward Dermatology and Cosmetic Specialists

  • Dermatology Physician
  • Fort Lauderdale, FL
  • NPI 1063760502
  NPD tax ID

Locations

Practitioners 1

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

• Jerome R Obed, DO

  • Dermatology Physician
  • Fort Lauderdale, FL
  • NPI 1720055585
  NPD Authorized official

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390953600000",
    "number": "1841555786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SE 15TH ST",
            "address_2": "SUITE #108",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161952",
            "telephone_number": "954-990-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SE 15TH ST",
            "address_2": "SUITE #108",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161952",
            "telephone_number": "954-990-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWARD DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-06",
        "last_updated": "2014-01-29",
        "status": "A",
        "authorized_official_last_name": "OBED",
        "authorized_official_first_name": "JEROME",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "954-990-6591",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "OS9463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "OS9463",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Broward County Home Health Care LLC (Comforcare Senior Services, Broward South)
• Broward County Minority Builders Coalition, Inc
• Broward County Physical Therapy, Inc
• Broward County Ryan White Part A Office
• Broward Dental Spa
• Broward Ear Nose Throat & Allergy PA
• Broward Eye Care LLC (Broward Eye Care Associates)
• Broward Family Physicians Inc
• Broward General Ekg Associates, Inc
• Broward General Medical Center

• Medical Specialty Clinic/Center in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Medical Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; 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.