Healthcare Provider Details

I. General information

NPI: 1265448286
Provider Name (Legal Business Name): SOUTH BROWARD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 10/12/2021
Certification Date: 10/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 JOHNSON ST
HOLLYWOOD FL
33021-6031
US

IV. Provider business mailing address

PO BOX 862233
ORLANDO FL
32886-2233
US

V. Phone/Fax

Practice location:
  • Phone: 954-987-2020
  • Fax: 954-965-6390
Mailing address:
  • Phone: 954-987-2020
  • Fax: 954-965-6390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: LEAH CARPENTER
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 954-265-2995