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NPI Code Detail

MEDICARE: SOUTH BROWARD HOSPITAL DISTRICT

MEDICARE: SOUTH BROWARD HOSPITAL DISTRICT
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
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1417491127
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH BROWARD HOSPITAL DISTRICT
Provider Business Mailing Address
First Line : 2900 CORPORATE WAY
Second Line : DOOR D
City : MIRAMAR
State : FL
Zip : 33025-3925
Country : US
Telephone Number : 954-276-5685
Fax Number : 954-985-7074
Provider Business Practice Location Address
First Line : 3440 HOLLYWOOD BLVD STE 360
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-6934
Country : US
Telephone Number : 954-276-9240
Fax Number : 954-276-0103
Authorized Official
Title or Position : CFO MPG AND MPC
Name : ESTHER SURUJON
Credential :
Telephone Number : 954-265-6677
Provider Enumeration Date : 12/14/2016
Last Update Date : 06/21/2023

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Directions to “SOUTH BROWARD HOSPITAL DISTRICT ” Practice Location

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