MEDICARE: BROWARD EAR NOSE THROAT & ALLERGY PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205890803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROWARD EAR NOSE THROAT & ALLERGY PA

Provider Business Mailing Address
First Line	:	1317 SE 4TH AVE
Second Line	:
City	:	FT. LAUDERDALE
State	:	FL
Zip	:	33316
Country	:	US
Telephone Number	:	954-583-7770
Fax Number	:	954-583-6226

Provider Business Practice Location Address
First Line	:	1317 SE 4TH AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316-1913
Country	:	US
Telephone Number	:	954-583-7770
Fax Number	:	954-583-6226

Authorized Official
Title or Position	:	PRIVATE PRACTITIONER IN GROUP PRACT
Name	:	DR. SABINE VERA HESSE
Credential	:	MD
Telephone Number	:	954-583-7770

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	04/09/2010

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