Healthcare Provider Details

I. General information

NPI: 1699761692
Provider Name (Legal Business Name): SOUTH FLORIDA HEART CENTER, P.L.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N 35TH AVE SUITE 440
HOLLYWOOD FL
33021-5424
US

IV. Provider business mailing address

PO BOX 816759
HOLLYWOOD FL
33081-0759
US

V. Phone/Fax

Practice location:
  • Phone: 954-962-5400
  • Fax: 954-966-2316
Mailing address:
  • Phone: 954-964-2450
  • Fax: 954-964-6084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL ROSENBLOOM
Title or Position: PRESIDENT
Credential: M.D.
Phone: 954-962-5400