MEDICARE: HOSPITAL WITHOUT WALLS OF BROWARD, INC.

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	251E00000X	Home Health Agency		FL

General Provider Information

NPI Number	:	1265541254
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPITAL WITHOUT WALLS OF BROWARD, INC.

Provider Business Mailing Address
First Line	:	2310 NW 3RD AVE
Second Line	:	SUITE 8
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060-4963
Country	:	US
Telephone Number	:	954-984-8485
Fax Number	:	954-984-0354

Provider Business Practice Location Address
First Line	:	2310 NW 3RD AVE
Second Line	:	SUITE 8
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060-4963
Country	:	US
Telephone Number	:	954-984-8485
Fax Number	:	954-984-0354

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. BAHER HABIB
Credential	:
Telephone Number	:	954-984-8485

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	08/06/2007

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