MEDICARE: BROWARD MEDICAL CENTER OF DAVIE INC

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	207Q00000X	Family Medicine Physician	OS5410	FL

General Provider Information

NPI Number	:	1376658294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROWARD MEDICAL CENTER OF DAVIE INC

Provider Business Mailing Address
First Line	:	1330 RIVERLAND RD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-2961
Country	:	US
Telephone Number	:	954-321-9826
Fax Number	:	954-321-9660

Provider Business Practice Location Address
First Line	:	1330 RIVERLAND RD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-2961
Country	:	US
Telephone Number	:	954-321-9826
Fax Number	:	954-321-9660

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT HUNT
Credential	:	D.O.
Telephone Number	:	954-321-9826

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	08/22/2020

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