NPIMap

Organization Active NPI

Florida Department of Health

  • State or Local Public Health Clinic/Center
  • Hollywood, FL
National Provider Identifier
1851436398
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
License
PH11860 Issued in FL
Legal business name
FLORIDA DEPARTMENT OF HEALTH
Practice address
4105 Pembroke Rd
Hollywood, FL 33021-8103
Phone
(954) 985-4861
Fax
(954) 985-4828
NPI assigned
Feb 21, 2007
Last updated
Jun 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Dr. Paula M Thaqi
Title
Director
Phone
(954) 467-4811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
State or Local Public Health Clinic/Center 261QP0905X PH11860 FL Primary

Addresses

Primary practice location

4105 Pembroke Rd
Hollywood, FL 33021-8103

Mailing address

4105 Pembroke Rd
Suite C107
Hollywood, FL 33021-8103
Phone (954) 985-4861

Other identifiers 1

IdentifierTypeStateIssuer
109974406MedicaidFL

Other names 1

  • BROWARD COUNTY HEALTH DEPT SRHC PHARMACY Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2342001Florida Department of Health4105 Pembroke Road Room 4, Hollywood, FL 33021Certificate of waiverApr 11, 2028

National Provider Directory

National Provider Directory
Tax ID family
Agape Community Health185 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

4105 Pembroke Rd
Ste C107
Hollywood, FL 33021

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1851436398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 PEMBROKE RD",
            "address_2": "SUITE C107",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218103",
            "telephone_number": "954-985-4861",
            "fax_number": "954-985-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 PEMBROKE RD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218103",
            "telephone_number": "954-985-4861",
            "fax_number": "954-985-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "THAQI",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "954-467-4811",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "FL",
            "license": "PH11860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109974406",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROWARD COUNTY HEALTH DEPT SRHC PHARMACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.