5630 LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

5630 LLC

Practice address

5630 Oaktree Ave
Fort Lauderdale, FL 33312-6375

Phone

(847) 571-4323

NPI assigned

Oct 28, 2024

Organization subpart

No

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

Authorized official

Name

Sam Judah Sugar, MD

Title

Owner

Phone

(847) 571-4323

Specialties & licenses 1

Addresses

Other names 1

• Sam Judah Sugar MD Doing business as

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1942022413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5630 OAKTREE AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333126375",
            "telephone_number": "847-571-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5630 OAKTREE AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333126375",
            "telephone_number": "847-571-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5630 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "SUGAR",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "JUDAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-571-4323",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sam Judah Sugar MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Fort Lauderdale, FL
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.