Healthcare Provider Details

I. General information

NPI: 1144360991
Provider Name (Legal Business Name): SOUTH BROWARD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N 35TH AVE SUITE 105
HOLLYWOOD FL
33021
US

IV. Provider business mailing address

1150 N 35TH AVE SUITE 105
HOLLYWOOD FL
33021
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-1299
  • Fax: 954-276-0292
Mailing address:
  • Phone: 954-265-1299
  • Fax: 954-276-0292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH8171
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: IRFAN MIRZA
Title or Position: INTERIM CHIEF FINANCIAL OFFICER
Credential:
Phone: 954-265-5696