Healthcare Provider Details

I. General information

NPI: 1720113400
Provider Name (Legal Business Name): NORTH BROWARD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 SE 3RD AVE STE 300
FORT LAUDERDALE FL
33316-2521
US

IV. Provider business mailing address

1608 SE 3RD AVE FL 3
FORT LAUDERDALE FL
33316-2564
US

V. Phone/Fax

Practice location:
  • Phone: 954-355-4665
  • Fax: 954-355-4881
Mailing address:
  • Phone: 954-355-4665
  • Fax: 954-355-4881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: KRYSTLE MARTIN
Title or Position: CFO
Credential:
Phone: 954-473-7420