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General NPI Number Information
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NPI Number | 1588907695
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Entity Type | Organization
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Legal Business Name | BROWARD OUTPATIENT MEDICAL CENTER
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Dates
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Enumeration Date | 03/27/2013
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 150 S ANDREWS AVE SUITE 201
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3298
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Country | US
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Telephone | 954-941-2969
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Fax | 954-960-6858
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Provider Business Mailing Address
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Address Line | 150 S ANDREWS AVE SUITE 201
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3298
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Country | US
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Telephone | 954-941-2969
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Fax | 954-960-6858
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MRS. STACEY B CASTROVINCI
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Credential | R.N.
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Telephone | 954-941-2969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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Taxonomy #6
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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