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	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00020	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952329419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH BROWARD HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	1700 NW 49TH ST STE 125
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3763
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 E SAMPLE RD
Second Line	:	SUITE 302
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-3552
Country	:	US
Telephone Number	:	954-421-9050
Fax Number	:	954-421-8712

Authorized Official
Title or Position	:	SVP/CFO
Name	:	ALEXANDER FERNANDEZ
Credential	:
Telephone Number	:	954-473-7315

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	05/25/2021

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