Southern Medical Services Group,Inc.

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

License

ME36479 Issued in FL

Legal business name

SOUTHERN MEDICAL SERVICES GROUP,INC.

Practice address

3342 NE 34TH St
Fort Lauderdale, FL 33308-6906

Phone

(954) 583-7267

Fax

(954) 583-0535

NPI assigned

Jul 10, 2007

Last updated

Oct 9, 2014By 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

Miss Priti M Shah

Title

Office Manager

Phone

(954) 583-7267

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412812800000",
    "number": "1881892073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3342 NE 34TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333086906",
            "telephone_number": "954-583-7267",
            "fax_number": "954-583-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3342 NE 34TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333086906",
            "telephone_number": "954-583-7267",
            "fax_number": "954-583-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MEDICAL SERVICES GROUP,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2014-10-09",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "PRITI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "954-583-7267",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "FL",
            "license": "ME36479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.