Broward Family Medical Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BROWARD FAMILY MEDICAL GROUP LLC

Practice address

2701 NE 14TH Street Cswy
Suite 5
Pompano Beach, FL 33062-3535

Phone

(954) 545-1560

Fax

(954) 545-1560

NPI assigned

Oct 30, 2007

Organization subpart

No

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

Authorized official

Name

Glen A Waskin, DONPI 1427167204

Title

Owner

Phone

(954) 545-1560

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Glen Andrew Waskin, DO

  • Family Medicine Physician
  • Pompano Beach, FL
  • NPI 1427167204
  Medicare reassignment NPD Authorized official
• Babak Sheikh, M.D.

  • Orthopaedic Surgery Physician
  • Lauderdale Lakes, FL
  • NPI 1922048172
  NPD (past)

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1992984652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 NE 14TH STREET CSWY",
            "address_2": "SUITE 5",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330623535",
            "telephone_number": "954-545-1560",
            "fax_number": "954-545-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 NE 14TH STREET CSWY",
            "address_2": "SUITE 5",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330623535",
            "telephone_number": "954-545-1560",
            "fax_number": "954-545-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWARD FAMILY MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "WASKIN",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-545-1560",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Pompano Beach, FL
• Providers in Pompano Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.