Organization Active NPI

Sulayman E Jallow MD PA

  • Ophthalmology Physician
  • Pembroke Pines, FL
National Provider Identifier
1922285170
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME0038394 Issued in FL
Legal business name
SULAYMAN E JALLOW MD PA
Practice address
601 N Flamingo Rd
Suite 413
Pembroke Pines, FL 33028-1015
Phone
(954) 436-7700
Fax
(954) 432-1769
NPI assigned
Jan 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Authorized official

Name
Dr. Sulayman E Jallow, MDNPI 1871555128
Title
Owner
Phone
(954) 436-7700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X ME0038394 FL Primary

Addresses

Primary practice location

601 N Flamingo Rd
Suite 413
Pembroke Pines, FL 33028-1015

Mailing address

601 N Flamingo Rd
Suite 413
Pembroke Pines, FL 33028-1015
Phone (954) 436-7700

Other identifiers 1

IdentifierTypeStateIssuer
066202000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080620000117 FL Part B Supplier - Clinic/Group Practice 9830260728 Receives reassigned benefits from 1 practitioner
Practice locations: Pembroke Pines, FL

National Provider Directory

National Provider Directory

Locations

601 N Flamingo Rd
Ste 413
Pembroke Pnes, FL 33028
Phone (305) 643-8871

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1922285170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N FLAMINGO RD",
            "address_2": "SUITE 413",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281015",
            "telephone_number": "954-436-7700",
            "fax_number": "954-432-1769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N FLAMINGO RD",
            "address_2": "SUITE 413",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281015",
            "telephone_number": "954-436-7700",
            "fax_number": "954-432-1769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULAYMAN E JALLOW MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "JALLOW",
        "authorized_official_first_name": "SULAYMAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-436-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0038394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066202000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.