Healthcare Provider Details
I. General information
NPI: 1386023216
Provider Name (Legal Business Name): NORTH BROWARD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/26/2015
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2300 N COMMERCE PKWY STE 303
WESTON FL
33326-3256
US
IV. Provider business mailing address
1700 NW 49TH ST STE 125
FORT LAUDERDALE FL
33309-3750
US
V. Phone/Fax
- Phone: 954-217-3171
- Fax: 954-217-3176
- Phone: 954-217-3171
- Fax: 954-217-3176
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0205X |
| Taxonomy | Pediatric Endocrinology Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0206X |
| Taxonomy | Pediatric Gastroenterology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALISA
BERT
Title or Position: INTERIM CFO
Credential:
Phone: 954-847-4117