Healthcare Provider Details

I. General information

NPI: 1164348314
Provider Name (Legal Business Name): SOUTH BROWARD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 N 35TH AVE STE 220
HOLLYWOOD FL
33021-5403
US

IV. Provider business mailing address

2900 CORPORATE WAY DOOR D
MIRAMAR FL
33025-3925
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-3030
  • Fax: 954-265-3065
Mailing address:
  • Phone: 954-276-5603
  • Fax: 954-985-7073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIO SALCEDA-CRUZ
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 954-276-9312