Carevantage Medical Centers of Broward at Stirling Road,LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

CAREVANTAGE MEDICAL CENTERS OF BROWARD AT STIRLING ROAD,LLC

Practice address

2536 N State Road 7
Hollywood, FL 33021-3205

Phone

(954) 983-8844

Fax

(954) 983-8855

NPI assigned

Dec 6, 2011

Last updated

Jan 24, 2023By 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

Alberto Lamadrid

Title

Owner

Phone

(786) 691-1110

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Noel E. Lezama, MD

  • General Practice Physician
  • Hialeah Gardens, FL
  • NPI 1275693137
  Medicare reassignment
• Rodney B. Rengifo, PA-C

  • Physician Assistant
  • Hialeah, FL
  • NPI 1275737306
  Medicare reassignment

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

{
    "created_epoch": "1323129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1972871937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2536 N STATE ROAD 7",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213205",
            "telephone_number": "954-983-8844",
            "fax_number": "954-983-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2536 N STATE ROAD 7",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213205",
            "telephone_number": "954-983-8844",
            "fax_number": "954-983-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREVANTAGE MEDICAL CENTERS OF BROWARD AT STIRLING ROAD,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-06",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "LAMADRID",
        "authorized_official_first_name": "ALBERTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-691-1110"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Esaie Carisma, D.O.
• Theresa A Carissimi, D.C.

• General Practice Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.