Healthcare Provider Details

I. General information

NPI: 1285420562
Provider Name (Legal Business Name): NORTH BROWARD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 E COMMERCIAL BLVD STE 202
FORT LAUDERDALE FL
33308-3754
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 954-202-7850
  • Fax:
Mailing address:
  • Phone: 954-202-7850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: KRYSTLE MARTIN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 954-473-7420