Organization Active NPI

My Doctor PA

  • Family Medicine Physician
  • Belle Glade, FL
National Provider Identifier
1992785513
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS-0005579 Issued in FL
Legal business name
MY DOCTOR PA
Practice address
1200 S Main St
Suite 200
Belle Glade, FL 33430-7808
Phone
(561) 992-8000
Fax
(561) 992-8020
NPI assigned
Jan 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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

Authorized official

Name
Martin Tracy Harland, D.O.NPI 1760462386
Title
President/Ceo
Phone
(561) 992-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS-0005579 FL Primary

Addresses

Primary practice location

1200 S Main St
Suite 200
Belle Glade, FL 33430-7808

Mailing address

1200 S Main St
Suite 200
Belle Glade, FL 33430-7808
Phone (561) 992-8000

Other identifiers 1

IdentifierTypeStateIssuer
253267100MedicaidFL

National Provider Directory

National Provider Directory

Locations

125 N Main St
Belle Glade, FL 33430
Phone (561) 795-3330

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303948800000",
    "number": "1992785513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S MAIN ST",
            "address_2": "SUITE 200",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334307808",
            "telephone_number": "561-992-8000",
            "fax_number": "561-992-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S MAIN ST",
            "address_2": "SUITE 200",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334307808",
            "telephone_number": "561-992-8000",
            "fax_number": "561-992-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY DOCTOR PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2011-04-28",
        "status": "A",
        "authorized_official_last_name": "HARLAND",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "TRACY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "561-992-8000",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS-0005579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253267100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belle Glade, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; 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.