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	261QR0206X	Mammography Clinic/Center	JR 37120000	FL
2	261QS1200X	Sleep Disorder Diagnostic Clinic/Center	10428	FL
3	261QR0200X	Radiology Clinic/Center	JR 37121000	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	V004E	OTHER	FL	BCBS OF FL
2	V2447	OTHER	FL	BCBS OF FL

General Provider Information

NPI Number	:	1831135565
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	:	33309-3763
Country	:	US
Telephone Number	:	954-217-3305
Fax Number	:	954-217-5778

Provider Business Practice Location Address
First Line	:	2300 N COMMERCE PKWY STE 101
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33326-3255
Country	:	US
Telephone Number	:	954-217-3305
Fax Number	:	954-217-5778

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

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	04/01/2024

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Directions to “NORTH BROWARD HOSPITAL DISTRICT ” Practice Location

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