DR. RAFAEL SEGUNDO BRICENO (NPI# 1174670863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174670863 |
| Entity Type | Individual |
| Full Name | DR. RAFAEL SEGUNDO BRICENO |
| Credential | M.D. |
| Practice Address |
3363 Sheridan St Suite 207 Hollywood FL 33021-3664 |
| Mailing Address |
Po Box 816759 Hollywood FL 33081-0759 |
| Practice Telephone | 9549642450 |
| Practice Fax Number | 9549646084 |
| Mailing Telephone | 9549642450 |
| Mailing Fax Number | 9549646084 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2013-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | A97677 | CA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | ME97155 | FL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | MD29002 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 003117000 | 05 | |
| FL | FLORIDA BLUE | 14P2T | 01 |
| Street Address |
3363 SHERIDAN ST SUITE 207 |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021-3664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467442236 | Robert A Green | Psychologist | 3363 Sheridan St, Ste 209, Hollywood, FL 33021-3664 | 2005-10-24 |
| 1710120464 | Mtr Medical Supply Inc. | Durable Medical Equipment & Medical Supplies | 3363 Sheridan St, Suite 212, Hollywood, FL 33021-3664 | 2009-04-10 |
| 1679602387 | Peilan Yao | Acupuncturist | 3363 Sheridan St, Suite 214, Hollywood, FL 33021-3658 | 2007-03-06 |
| 1306862297 | Randy Levine | Psychologist | 3363 Sheridan St, Suite 209, Hollywood, FL 33021-3664 | 2006-07-14 |
| 1518923812 | Farrar Valine Duro | Acupuncturist | 3363 Sheridan St, Suite 214, Hollywood, FL 33021-3664 | 2006-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548893894 | Seminole Tribe of Florida Health Department | Pharmacy | 111 W. Coral Way, Hollywood, FL 33021 | 2020-02-14 |
| 1437714086 | Emilia Roxana Gucciardo | Physician Assistant | 4510 Sheridan Street, Attn: William Pepe, Hollywood, FL 33021 | 2019-05-08 |
| 1649763673 | Sabrina Shoba Mathura | Behavior Technician | 4400 Madison St, Hollywood, FL 33021 | 2018-06-13 |
| 1558850149 | South Broward Hospital District | Pediatrics | 105 Joe Dimaggio Dr, Pediatric Heart Station, Hollywood, FL 33021 | 2018-05-09 |
| 1942798368 | Kyndra Monique Liburd | Student in an Organized Health Care Education/Training Program | Attn: Pediatric Residency Program, 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2018-05-01 |
| 1992292106 | Madeleine Mariela Reyes | Nurse Practitioner | 5010 Hollywood Boulevard #100-b, Hollywood, FL 33021 | 2018-04-13 |
| 1487168233 | Gynecologic Oncology & Urogynecology | Obstetrics & Gynecology | 1150 N 35th Ave Ste 670, Hollywood, FL 33021 | 2017-11-30 |
| 1245743012 | Healix Healthcare Services, LLC | Obstetrics & Gynecology | 3990 Sheridan St Ste 207, Hollywood, FL 33021 | 2017-11-14 |
| 1093233587 | Benjamin Laborde | Physical Therapy Assistant | 4200 Washington Street, Hollywood, FL 33021 | 2017-09-05 |
| 1477079358 | Tt Trans, LLC | Non-emergency Medical Transport (VAN) | 3550 Washington Street, 502, Hollywood, FL 33021 | 2017-08-22 |
| Find all providers in zip 33021 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336752088 | Christy Nicole Johnson | Family Medicine | 634 Drew Dr, Hollywood, AL 35752-6556 | 2020-08-24 |
| 1669931762 | Premier Healthcare Centers, LLC | Family Medicine | 9950 Stirling Rd Ste 108, Hollywood, FL 33024-8001 | 2019-03-18 |
| 1689026460 | Sanrol Medical Center Inc | Family Medicine | 7160 Stirling Rd, Hollywood, FL 33024-1650 | 2016-07-06 |
| 1366896904 | South Florida Family Medical Center, LLC. | Family Medicine | 7369 Sheridan St Ste 100, Hollywood, FL 33024 | 2016-04-20 |
| 1790032530 | Kyle Petersen | Family Medicine | 3157 N University Dr Ste 101, Hollywood, FL 33024-2258 | 2012-08-10 |
| 1184989139 | Evgeny Goldman | Family Medicine | 6100 Hollywood Blvd Ste 300, Hollywood, FL 33024-7982 | 2012-07-05 |
| 1699047654 | Gg Healthcare Pa | Family Medicine | 6241 Pembroke Rd, Hollywood, FL 33023-2215 | 2012-02-06 |
| 1285932947 | Frank C Alario Md Pl | Family Medicine | 5700 Stirling Rd Ste 100, Hollywood, FL 33021-1522 | 2011-03-04 |
| 1982835559 | Maria Strimbu | Family Medicine | 4030 Sheridan St Ste A, Hollywood, FL 33021-3564 | 2009-07-30 |
| 1396998944 | Wilson Izquierdo | Family Medicine | 2229 Sheridan St, Hollywood, FL 33020-2040 | 2008-10-28 |
| Find all providers in HOLLYWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.