=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972750321
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTH BROWARD HOSPITAL DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/27/2008
-----------------------------------------------------
Last Update Date | 12/09/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1529 SE 4TH AVE
-----------------------------------------------------
City | FORT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33316-2541
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-712-9993
-----------------------------------------------------
Fax | 954-712-9934
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 862851
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32886-2851
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-847-4273
-----------------------------------------------------
Fax | 954-847-4245
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | MR. FRANK P NASK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 954-355-2064
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------