Healthcare Provider Details

I. General information

NPI: 1457763740
Provider Name (Legal Business Name): NORTH BROWARD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2014
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 SE 3RD AVE SUITE 601
FORT LAUDERDALE FL
33316-2521
US

IV. Provider business mailing address

1700 NW 49TH ST STE 125
FORT LAUDERDALE FL
33309-3750
US

V. Phone/Fax

Practice location:
  • Phone: 954-355-4617
  • Fax: 954-355-4618
Mailing address:
  • Phone: 954-355-4617
  • Fax: 954-355-4618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ALISA BERT
Title or Position: INTERIM CFO
Credential:
Phone: 954-847-4117