MEDICARE: NORTH 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
1	207VM0101X	Maternal & Fetal Medicine Physician
2	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1629944871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH BROWARD HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	1608 SE 3RD AVE FL 3
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-2564
Country	:	US
Telephone Number	:	954-473-7642
Fax Number	:	954-888-3907

Provider Business Practice Location Address
First Line	:	950 S PINE ISLAND RD STE A-180
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-3926
Country	:	US
Telephone Number	:	954-712-6355
Fax Number	:	954-888-3993

Authorized Official
Title or Position	:	CFO
Name	:	KRYSTLE MARTIN
Credential	:
Telephone Number	:	954-473-7420

Provider Enumeration Date	:	10/15/2025
Last Update Date	:	10/15/2025

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Directions to “NORTH BROWARD HOSPITAL DISTRICT ” Practice Location

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