Healthcare Provider Details

I. General information

NPI: 1043028475
Provider Name (Legal Business Name): NORTH BROWARD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6405 N FEDERAL HWY STE 404
FORT LAUDERDALE FL
33308-1414
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 954-940-7015
  • Fax: 954-888-3755
Mailing address:
  • Phone: 954-940-7015
  • Fax: 954-888-3755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

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