Provider Demographics
NPI:1316018146
Name:IVERS, JAMES J (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:IVERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3601 SW 160TH AVE
Mailing Address - Street 2:SUITE #250
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-6308
Mailing Address - Country:US
Mailing Address - Phone:305-866-9951
Mailing Address - Fax:877-284-8933
Practice Address - Street 1:3601 SW 160TH AVE
Practice Address - Street 2:SUITE #250
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-6308
Practice Address - Country:US
Practice Address - Phone:305-866-9951
Practice Address - Fax:877-284-8933
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA43708207Q00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAN01874OtherBLUE CROSS
MAP00772236OtherRAILROAD MEDICARE
MA043708OtherTUFTS HEALTH PLAN
MA0005333OtherNEIGHBORHOOD HEALTH PLAN
MA3010147Medicaid
MA4247299OtherAETNA
MA24199OtherFALLON
MAAA17609OtherHARVARD PILGRIM
MAN01874OtherBLUE CROSS
MAAA17609OtherHARVARD PILGRIM
MAA68013Medicare UPIN
MAN0187402Medicare PIN