MEMORIAL PRIMARY CARE SPORTS MEDICINE
NPI 1548937907
Clinic/Center - Multi-Specialty in Miramar, FL
NPI Status: Active since August 24, 2021
Contact Information
1951 SW 172ND AVE STE 405
MIRAMAR, FL
ZIP 33029
Phone: (954) 265-7550
Fax: (954) 276-0250
- Organization
- Clinic/Center
- Multi-Specialty
- Accepts Insurance
- CLIA Number: 10D1096358
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 03-02-2027
About MEMORIAL PRIMARY CARE SPORTS MEDICINE
This page provides the complete NPI Profile along with additional information for Memorial Primary Care Sports Medicine, a provider established in Miramar, Florida operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1548937907 assigned on August 2021. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as Memorial Primary Care Sports Medicine. The authorized official of this NPI record is Esther Surujon (Cfo Mpg, Mpc And Ucc)
- NPI
- 1548937907
- Provider Legal Name
- SOUTH BROWARD HOSPITAL DISTRICT
- Other Organization Name
- MEMORIAL PRIMARY CARE SPORTS MEDICINE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1951 SW 172ND AVE STE 405 MIRAMAR, FL 33029
- Location Phone
- (954) 265-7550
- Location Fax
- (954) 276-0250
- Mailing Address
- 2900 CORPORATE WAY DOOR D MIRAMAR, FL 33025
- Mailing Phone
- (954) 276-5685
- Mailing Fax
- (954) 276-0250
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 08-24-2021
- Last Update Date
- 08-30-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- AvMed Entrust Bronze 600 (2026) - HMO
- AvMed Entrust Bronze 650 (2026) - HMO
- AvMed Entrust Expanded Bronze Standard (2026) - HMO
- AvMed Entrust Gold 125 (2026) - HMO
- AvMed Entrust Gold 125 Dental+Vision (2026) - HMO
- AvMed Entrust Gold Standard (2026) - HMO
- AvMed Entrust Platinum 25 (2026) - HMO
- AvMed Entrust Platinum 25 Dental+Vision (2026) - HMO
- AvMed Entrust Platinum Standard (2026) - HMO
- AvMed Entrust Silver 350 (2026) - HMO
- AvMed Entrust Silver 350 Dental+Vision (2026) - HMO
- AvMed Entrust Silver 550 (2026) - HMO
- AvMed Entrust Silver 550 Dental+Vision (2026) - HMO
- AvMed Entrust Silver Standard (2026) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D1096358
- Facility Type
- Physician Office
- Certificate Effective Date
- March 03, 2025
- Certificate Expiration Date
- March 02, 2027
- Laboratory Director
- LAURA WEAVER LONDON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Memorial Primary Care Sports Medicine to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1548937907, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 73 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
MIRAMAR, FL 33029
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1548937907, enumerated as an "organization" on August 24, 2021.
The provider is located at 1951 SW 172ND AVE STE 405 MIRAMAR, FL 33029 and the phone number is (954) 265-7550.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
The provider might be accepting Accepts: AvMed. Please consult your insurance carrier or call the provider to verify.
