Intracoastal Medical Primary Health Care, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INTRACOASTAL MEDICAL PRIMARY HEALTH CARE, INC

Practice address

935 Intracoastal Dr
Suite 1
Fort Lauderdale, FL 33304-3623

Phone

(954) 561-6252

Fax

(954) 530-7516

NPI assigned

May 24, 2012

Last updated

Jun 17, 2013By 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

Harish Chowdary, MD

Title

DPST

Phone

(786) 302-4902

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371427200000",
    "number": "1861752784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 INTRACOASTAL DR",
            "address_2": "SUITE 1",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043623",
            "telephone_number": "954-561-6252",
            "fax_number": "954-530-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 INTRACOASTAL DR",
            "address_2": "SUITE 1",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043623",
            "telephone_number": "954-561-6252",
            "fax_number": "954-530-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTRACOASTAL MEDICAL PRIMARY HEALTH CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-24",
        "last_updated": "2013-06-17",
        "status": "A",
        "authorized_official_last_name": "CHOWDARY",
        "authorized_official_first_name": "HARISH",
        "authorized_official_title_or_position": "DPST",
        "authorized_official_telephone_number": "786-302-4902",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; 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.