MEDICARE: SOUTH 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	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician

General Provider Information

NPI Number	:	1962991562
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH BROWARD HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	2900 CORPORATE WAY
Second Line	:	DOOR D
City	:	MIRAMAR
State	:	FL
Zip	:	33025-3925
Country	:	US
Telephone Number	:	954-276-5685
Fax Number	:	954-985-7074

Provider Business Practice Location Address
First Line	:	3501 JOHNSON ST FL 1
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021
Country	:	US
Telephone Number	:	954-265-7750
Fax Number	:	954-276-0280

Authorized Official
Title or Position	:	CFO MEMORIAL PHYSICIAN GROUP & MPC
Name	:	ESTHER SURUJON
Credential	:
Telephone Number	:	954-265-6677

Provider Enumeration Date	:	05/09/2018
Last Update Date	:	03/05/2026

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Directions to “SOUTH BROWARD HOSPITAL DISTRICT ” Practice Location

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