MEDICARE: COUNTY OF BROWARD OFFICE OF THE SHERIFF

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	341600000X	Ambulance	3215	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A0692	OTHER	FL	PART B MEDICARE #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	590011345	OTHER		RAILROAD PROVIDER ID

General Provider Information

NPI Number	:	1437262565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF BROWARD OFFICE OF THE SHERIFF

Provider Business Mailing Address
First Line	:	PO BOX 919068
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32891-9068
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 W BROWARD BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-1308
Country	:	US
Telephone Number	:	954-831-8291
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF FIRE RESCUE
Name	:	CHARLES LANZA
Credential	:
Telephone Number	:	954-831-8291

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	03/25/2011

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