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  7. NPI Record 1396175089

BROWARD PRIMARY CARE CLINICS INC
Complete NPI Record 1396175089
Legal Medicine in Plantation, FL

NPI Status: Active since November 18, 2013

Contact Information

660 N STATE ROAD 7
SUITE:2
PLANTATION, FL
ZIP 33317
Phone: (954) 288-9338

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Second Line Business Mailing Address
  7. Provider Business Mailing Address City Name
  8. Provider Business Mailing Address State Name
  9. Provider Business Mailing Address Postal Code
  10. Provider Business Mailing Address Country Code If outside U S
  11. Provider Business Mailing Address Telephone Number
  12. Provider First Line Business Practice Location Address
  13. Provider Second Line Business Practice Location Address
  14. Provider Business Practice Location Address City Name
  15. Provider Business Practice Location Address State Name
  16. Provider Business Practice Location Address Postal Code
  17. Provider Business Practice Location Address Country Code If outside U S
  18. Provider Business Practice Location Address Telephone Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Authorized Official Last Name
  22. Authorized Official First Name
  23. Authorized Official Title or Position
  24. Authorized Official Telephone Number
  25. Healthcare Provider Taxonomy Code 1
  26. Provider License Number 1
  27. Provider License Number State Code 1
  28. Healthcare Provider Primary Taxonomy Switch 1
  29. Is Organization Subpart
  30. Healthcare Provider Taxonomy Group 1

Complete NPI Dataset

This page represents the complete record for NPI 1396175089. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1396175089
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider First Line Business Mailing Address: 660 N STATE ROAD 7
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Second Line Business Mailing Address: SUITE:2
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Business Mailing Address City Name: PLANTATION
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address State Name: FL
The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address Postal Code: 333172117
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address Country Code If outside U S : US
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Telephone Number: 9542889338
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider First Line Business Practice Location Address: 660 N STATE ROAD 7
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Second Line Business Practice Location Address: SUITE:2
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Practice Location Address City Name: PLANTATION
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider Business Practice Location Address State Name: FL
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address Postal Code: 333172117
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address Country Code If outside U S : US
The city name in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9542889338
The State code in the location of the provider being identified.
Provider Enumeration Date: 11/18/2013
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Last Update Date: 1/16/2014
The date that a record was last updated or changed.
Authorized Official Last Name: PENA
The telephone number associated with the location address of the provider being identified.
Authorized Official First Name: CLAUDIA
The fax number associated with the location address of the provider being identified.
Authorized Official Title or Position: OWNER
The date the provider was assigned a unique identifier (assigned an NPI).
Authorized Official Telephone Number: 9542889338
The date that a record was last updated or changed.
Healthcare Provider Taxonomy Code 1: 173000000X
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Provider License Number 1: ME87727
The first name of the authorized official.
Provider License Number State Code 1: FL
The title or position of the authorized official.
Healthcare Provider Primary Taxonomy Switch 1: Y
The 10-position telephone number of the authorized official.
Is Organization Subpart: N
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP