Organization Active NPI

South Broward Vascular Associates LLC

  • Vascular Surgery Physician
  • Hollywood, FL
National Provider Identifier
1215165121
Registry record updated Aug 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME71836 Issued in FL
Legal business name
SOUTH BROWARD VASCULAR ASSOCIATES LLC
Practice address
3850 Hollywood Blvd
302
Hollywood, FL 33021-6748
Phone
(954) 989-5533
Fax
(954) 989-5677
NPI assigned
Jun 30, 2009
Last updated
Aug 24, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2009

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

Authorized official

Name
Jeffrey A Hertz, M.D.
Title
Vice President
Phone
(954) 989-5533

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X ME71836 FL Primary

Addresses

Primary practice location

3850 Hollywood Blvd
302
Hollywood, FL 33021-6748

Mailing address

3850 Hollywood Blvd
302
Hollywood, FL 33021-6748
Phone (954) 989-5533

National Provider Directory

National Provider Directory

Locations

1150 N 35th Ave
Ste 460
Hollywood, FL 33021
Phone (954) 265-1125

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251072000000",
    "number": "1215165121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 HOLLYWOOD BLVD",
            "address_2": "302",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216748",
            "telephone_number": "954-989-5533",
            "fax_number": "954-989-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 HOLLYWOOD BLVD",
            "address_2": "302",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216748",
            "telephone_number": "954-989-5533",
            "fax_number": "954-989-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BROWARD VASCULAR ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-08-24",
        "status": "A",
        "authorized_official_last_name": "HERTZ",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "954-989-5533",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME71836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.