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General NPI Number Information
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NPI Number | 1174942783
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Entity Type | Organization
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Legal Business Name | SOUTH BROWARD HOSPITAL DISTRICT
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Dates
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Enumeration Date | 04/10/2014
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Last Update Date | 06/26/2024
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Provider Practice Location Address
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Address Line | 1150 N 35TH AVE SUITE 130
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City | HOLLYWOOD
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State | FL
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Zip | 33021-5424
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Country | US
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Telephone | 954-265-6941
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Fax | 954-893-3799
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Provider Business Mailing Address
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Address Line | 2900 CORPORATE WAY MPG DOOR D
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City | MIRAMAR
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State | FL
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Zip | 33025-3925
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Country | US
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Telephone | 954-276-5615
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | NINA BEAUCHESNE
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Credential |
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Telephone | 954-265-6996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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