South Broward Hospital District

Primary specialty

Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X

Legal business name

SOUTH BROWARD HOSPITAL DISTRICT

Doing business as

Memorial Division of Pediatric Otolaryngology

Practice address

1131 N 35TH Ave Ste 300
Hollywood, FL 33021-5403

Phone

(954) 265-3030

Fax

(954) 893-6301

NPI assigned

May 3, 2011

Last updated

May 13, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTH BROWARD HOSPITAL DISTRICTAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Esther Surujon

Title

Cfo MPG, MPC and Ucc

Phone

(954) 265-6677

Specialties & licenses 1

Addresses

Other names 1

• Memorial Division of Pediatric Otolaryngology Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Part of

Memorial Hosp Div Ortho

Locations

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Aaron Fridman, PA-C

  • Physician Assistant
  • Weston, FL
  • NPI 1326697483
  Medicare reassignment Care Compare group NPD
• Alexis Jones

  • Physician Assistant
  • Davie, FL
  • NPI 1629764212
  Medicare reassignment Care Compare group NPD
• Cassidy Taylor Marrero

  • Student in an Organized Health Care Education/Training Program
  • Davie, FL
  • NPI 1669060570
  Medicare reassignment Care Compare group NPD
• Margaret Storm McGuiness, AUD

  • Audiologist
  • Coral Springs, FL
  • NPI 1679458160
  Medicare reassignment Care Compare group NPD
• Denise Aviva Sherman, MD

  • Pediatric Otolaryngology Physician
  • Gainesville, FL
  • NPI 1447365424
  Medicare reassignment Care Compare group NPD
• Leonor Sink Roach, AU.D.

  • Audiologist
  • Hollywood, FL
  • NPI 1538578810
  Medicare reassignment Care Compare group NPD
• Leonardo Antonio Torres, M.D.

  • Pediatric Otolaryngology Physician
  • Miami, FL
  • NPI 1912106220
  Medicare reassignment Care Compare group NPD
• Rena Levy, AU.D

  • Audiologist
  • Pittsburgh, PA
  • NPI 1053745182

  FL

  Medicare reassignment Care Compare group NPD
• Samantha Britni Allen, MD

  • Pediatric Otolaryngology Physician
  • Hollywood, FL
  • NPI 1578957486
  Medicare reassignment NPD
• Aiysha C Balbosa, D.O.

  • Pediatric Otolaryngology Physician
  • Coral Springs, FL
  • NPI 1295928380
  Medicare reassignment NPD
• Wendy Rachel Bayless

  • Physician Assistant
  • Hollywood, FL
  • NPI 1124735584
  Medicare reassignment NPD
• Yelena Victorovna Bondar, ARNP-BC

  • Family Nurse Practitioner
  • Miami, FL
  • NPI 1346419363
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1063704559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 N 35TH AVE STE 300",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215403",
            "telephone_number": "954-265-3030",
            "fax_number": "954-893-6301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1971 SW 172nd Ave Ste 2300",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330295625",
            "country_code": "US",
            "telephone_number": "954-265-1616",
            "fax_number": "954-265-1617",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4651 Sheridan St Ste 150",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330213443",
            "country_code": "US",
            "telephone_number": "954-276-1550",
            "fax_number": "954-893-6243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3377 S State Road 7 Ste 100",
            "address_purpose": "LOCATION",
            "city": "Wellington",
            "state": "FL",
            "postal_code": "334498002",
            "country_code": "US",
            "telephone_number": "561-341-7000",
            "fax_number": "561-784-7098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5830 Coral Ridge Dr Ste 140",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330763388",
            "country_code": "US",
            "telephone_number": "954-265-1616",
            "fax_number": "954-893-6301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH BROWARD HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH BROWARD HOSPITAL DISTRICT",
        "enumeration_date": "2011-05-03",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "SURUJON",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_title_or_position": "CFO MPG, MPC AND UCC",
        "authorized_official_telephone_number": "954-265-6677"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Division of Pediatric Otolaryngology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Browaid Brace Inc
• South Broward Hospital District (Memorial Division of High Risk Obstetrics)
• South Broward Hospital District (Memorial Division of Pediatric Psychology Services)
• South Broward Hospital District (Memorial Division of Endocrine Surgery)
• South Broward Hospital District (Memorial Division of Pediatric Complex Care)
• South Broward Hospital District (Memorial Cancer Institute)
• South Broward Hospital District (Memorial Division of Kidney Transplant)
• South Broward Hospital District (Memorial Division of Cardiac Electrophysiology)
• South Broward Hospital District (Memorial Division of Neurosurgery (Pediatrics and Adult))
• South Broward Hospital District (Memorial Regional Outpatient Pharmacy)

• Pediatric Otolaryngology Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Pediatric Otolaryngology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.