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
1	207R00000X	Internal Medicine Physician
2	207V00000X	Obstetrics & Gynecology Physician
3	261QF0400X	Federally Qualified Health Center (FQHC)

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	:	1669884854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH BROWARD HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	1700 NW 49TH ST STE 125
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3750
Country	:	US
Telephone Number	:	954-759-7557
Fax Number	:

Provider Business Practice Location Address
First Line	:	3716 W OAKLAND PARK BLVD
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33311-1134
Country	:	US
Telephone Number	:	954-759-7557
Fax Number	:	954-733-9155

Authorized Official
Title or Position	:	INTERIM CFO
Name	:	ALISA BERT
Credential	:
Telephone Number	:	954-847-4117

Provider Enumeration Date	:	05/22/2014
Last Update Date	:	10/15/2024

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Practice Location Address:

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1831153733 — KIM D JOLLY ARNP
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1619727229 — TRENIA SLAYDEN APRN
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1629927884 — AT-HOME CARE SERVICES
Practice Location Address:

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1871450650 — MS. MONIQUE BARNETT MSN, APRN, PMHNP
Practice Location Address:

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Practice Location Address:

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Directions to “NORTH BROWARD HOSPITAL DISTRICT ” Practice Location

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