Healthcare Provider Details

I. General information

NPI: 1477598290
Provider Name (Legal Business Name): NORTH BROWARD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 06/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E SAMPLE RD
POMPANO BEACH FL
33064-3502
US

IV. Provider business mailing address

PO BOX 862851
ORLANDO FL
32886-2851
US

V. Phone/Fax

Practice location:
  • Phone: 954-941-8300
  • Fax: 954-847-4245
Mailing address:
  • Phone: 954-847-4273
  • Fax: 954-847-4245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH1276
License Number StateFL

VIII. Authorized Official

Name: GINO SANTORIO
Title or Position: PRESIDENT / CEO
Credential:
Phone: 954-473-7024