MEDICARE: DOH BROWARD COUNTY PUBLIC HEALTH UNIT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP0905X	State or Local Public Health Clinic/Center	PH13091	FL

General Provider Information

NPI Number	:	1013006899
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOH BROWARD COUNTY PUBLIC HEALTH UNIT

Provider Business Mailing Address
First Line	:	4100 S HOSPITAL DR
Second Line	:	SUITE 309
City	:	PLANTATION
State	:	FL
Zip	:	33317-2813
Country	:	US
Telephone Number	:	954-327-5993
Fax Number	:	954-321-3763

Provider Business Practice Location Address
First Line	:	4100 S HOSPITAL DR
Second Line	:	SUITE 309
City	:	PLANTATION
State	:	FL
Zip	:	33317-2813
Country	:	US
Telephone Number	:	954-327-5993
Fax Number	:	954-321-3763

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. DAVID L ROACH
Credential	:
Telephone Number	:	954-467-4811

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	08/22/2020

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Directions to “DOH BROWARD COUNTY PUBLIC HEALTH UNIT ” Practice Location

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