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	207R00000X	Internal Medicine Physician

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	:	1952740458
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	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1811 N PINE ISLAND RD
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33322-5207
Country	:	US
Telephone Number	:	954-320-3360
Fax Number	:	954-473-2327

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	GINO SANTORIO
Credential	:
Telephone Number	:	954-473-7024

Provider Enumeration Date	:	06/18/2013
Last Update Date	:	07/30/2019

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Directions to “NORTH BROWARD HOSPITAL DISTRICT ” Practice Location

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