Healthcare Provider Details
I. General information
NPI: 1710793187
Provider Name (Legal Business Name): NORTH BROWARD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/10/2024
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1625 SE 3RD AVE STE 415-A
FORT LAUDERDALE FL
33316-2591
US
IV. Provider business mailing address
1608 SE 3RD AVE FL 3
FORT LAUDERDALE FL
33316-2564
US
V. Phone/Fax
- Phone: 954-958-9959
- Fax: 855-855-2793
- Phone: 954-958-9959
- Fax: 855-855-2793
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALISA
BERT
Title or Position: INTERIM CFO
Credential:
Phone: 954-473-7483