North Broward Hospital District
Organization Active NPI Hospice and Palliative Medicine (Family Medicine) Physician · Fort Lauderdale, FL
NPI 1114164282 · NPPES record last updated Mar 29, 2024
Key facts
- NPI
- 1114164282
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X
- Legal business name
- NORTH BROWARD HOSPITAL DISTRICT
- Practice address
- 1625 SE 3Rd Ave Ste 610
Fort Lauderdale, FL 33316-2521 - Phone
- (954) 848-8133
- Fax
- (954) 848-8143
- NPI assigned
- Jan 12, 2009
- Organization subpart
- Yes
- Parent organization (as reported)
- NORTH BROWARD HOSPITAL DISTRICT
Authorized official
- Name
- Alisa Bert
- Title
- Cfo
- Phone
- (954) 847-4117
Corporate family (same tax ID) 23
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040405001860 | FL | Part B Supplier - Clinic/Group Practice | 3577472422 |
Receives reassigned benefits from 251 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Robert L Odell MD
- Part of
- Robert L Odell MD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Family Medicine) Physician |
207QH0002X | Yes |
Addresses
Primary practice location
1625 SE 3Rd Ave Ste 610
Fort Lauderdale, FL 33316-2521
Mailing address
1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3750
Phone (954) 848-8133
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00020 | Other | FL | BCBS |
| 253794036 | Medicaid | FL |
Other names
- BH Physicians Main
Other providers in Fort Lauderdale, FL
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
All providers in Fort Lauderdale, FL · Hospice and Palliative Medicine (Family Medicine) Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.