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NPI Code Detail

MEDICARE: SOUTH BROWARD HOSPITAL DISTRICT

MEDICARE: SOUTH BROWARD HOSPITAL DISTRICT
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
12084P0804XChild & Adolescent Psychiatry Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336504075
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH BROWARD HOSPITAL DISTRICT
Provider Business Mailing Address
First Line : 2900 CORPORATE WAY
Second Line : MPG DOOR D
City : MIRAMAR
State : FL
Zip : 33025-3925
Country : US
Telephone Number : 954-276-3254
Fax Number : 954-276-0154
Provider Business Practice Location Address
First Line : 3440 HOLLYWOOD BLVD STE 360
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-6934
Country : US
Telephone Number : 954-276-9200
Fax Number : 954-275-0733
Authorized Official
Title or Position : CFO MPG, MPC AND UCC
Name : ESTHER SURUJON
Credential :
Telephone Number : 954-265-6677
Provider Enumeration Date : 12/23/2015
Last Update Date : 07/14/2025

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Directions to “SOUTH BROWARD HOSPITAL DISTRICT ” Practice Location

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