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General NPI Number Information
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NPI Number | 1376627778
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Entity Type | Organization
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Legal Business Name | DOH BROWARD COUNTY PUBLIC HEALTH UNIT
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 333 SW 28TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33315-2637
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Country | US
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Telephone | 954-467-4877
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Fax | 954-467-4878
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Provider Business Mailing Address
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Address Line | 333 SW 28TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33315-2637
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Country | US
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Telephone | 954-467-4877
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Fax | 954-467-4878
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. DAVID L ROACH
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Credential |
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Telephone | 954-467-4811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number | PH6758
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License Number State | FL
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