Healthcare Provider Details

I. General information

NPI: 1912710633
Provider Name (Legal Business Name): NORTH BROWARD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 SE 3RD AVE STE 620
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: 954-320-3380
  • Fax: 954-320-3371
Mailing address:
  • Phone: 954-320-3380
  • Fax: 954-320-3371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALISA BERT
Title or Position: INTERIM CFO
Credential:
Phone: 954-473-7483