Healthcare Provider Details

I. General information

NPI: 1558473488
Provider Name (Legal Business Name): SOUTH BROWARD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4105 PEMBROKE RD
HOLLYWOOD FL
33021-8103
US

IV. Provider business mailing address

4105 PEMBROKE RD
HOLLYWOOD FL
33021-8103
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-8486
  • Fax: 954-985-4899
Mailing address:
  • Phone: 954-265-8486
  • Fax: 954-985-4899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH22122
License Number StateFL

VIII. Authorized Official

Name: IRFAN MIRZA
Title or Position: INTERIM CHIEF FINANCIAL OFFICER
Credential:
Phone: 954-265-5636