Healthcare Provider Details

I. General information

NPI: 1578932687
Provider Name (Legal Business Name): SOUTH BROWARD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2015
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3341 JOHNSON ST
HOLLYWOOD FL
33021-5419
US

IV. Provider business mailing address

2900 CORPORATE WAY DOOR D
MIRAMAR FL
33025
US

V. Phone/Fax

Practice location:
  • Phone: 954-844-9080
  • Fax: 954-844-9081
Mailing address:
  • Phone: 954-276-5603
  • Fax: 954-276-0668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ESTHER SURUJON
Title or Position: CFO MPG, MPC & UCC
Credential:
Phone: 954-265-6777