| Prestige Clinicians Llc | |
|
4513 Nw 31st Ave Ste 1 Oakland Park FL 33309-3403 | |
| (954) 496-2599 | |
| (954) 337-0236 |
| Full Name | Prestige Clinicians Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4513 Nw 31st Ave Ste 1, Oakland Park, Florida |
| Authorized Official Name and Position | Henry Odazie (FNP) |
| Authorized Official Contact | 9544962599 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prestige Clinicians Llc 4513 Nw 31st Ave Ste 1 Oakland Park FL 33309-3403 Ph: (954) 496-2599 | Prestige Clinicians Llc 4513 Nw 31st Ave Ste 1 Oakland Park FL 33309-3403 Ph: (954) 496-2599 |
| NPI Number | 1497213755 |
|---|---|
| Provider Enumeration Date | 03/06/2019 |
| Last Update Date | 03/20/2024 |
| Medicare PECOS PAC ID | 9234549841 |
|---|---|
| Medicare Enrollment ID | O20201111000879 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497213755 | NPI | - | NPPES |
| Provider Name | Henry Odazie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740880848 PECOS PAC ID: 4688084296 Enrollment ID: I20201111001171 |
| Provider Name | Chinedu O Okeke |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1942663364 PECOS PAC ID: 6901190230 Enrollment ID: I20211108002519 |
| Provider Name | Ca'seem Tyler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912507500 PECOS PAC ID: 2365856879 Enrollment ID: I20220321001626 |
| Provider Name | Ahmed Riaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467959908 PECOS PAC ID: 5395097976 Enrollment ID: I20220713000380 |
| Provider Name | Mark Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497183404 PECOS PAC ID: 4880050228 Enrollment ID: I20230510000827 |
| Provider Name | Nosa Erhabor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265212765 PECOS PAC ID: 9830531235 Enrollment ID: I20240530004113 |
| Provider Name | Stephanie Higgins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699452912 PECOS PAC ID: 2769925007 Enrollment ID: I20240614002999 |
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