MEDICARE: NORTH 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
1	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1588598478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH BROWARD HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	1608 SE 3RD AVE FL 3
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-2564
Country	:	US
Telephone Number	:	954-355-4535
Fax Number	:	954-888-3575

Provider Business Practice Location Address
First Line	:	2611 E OAKLAND PARK BLVD STE 320
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1602
Country	:	US
Telephone Number	:	954-355-4535
Fax Number	:	954-888-3575

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	KRYSTLE MARTIN
Credential	:
Telephone Number	:	954-473-7420

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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