NPIMap

Organization Active NPI

South Broward Hospital District

Doing business as Memorial Cancer Institute Center for Body, Mind and Spirit

  • Durable Medical Equipment & Medical Supplies
  • Pembroke Pines, FL
National Provider Identifier
1225284292
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
4316 Issued in FL
Legal business name
SOUTH BROWARD HOSPITAL DISTRICT
Doing business as
Memorial Cancer Institute Center for Body, Mind and Spirit
Practice address
12235 Pines Blvd Ste 1101
Pembroke Pines, FL 33026-4119
Phone
(954) 844-7199
Fax
(954) 844-7155
NPI assigned
Aug 11, 2008
Last updated
Feb 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

Name
Leah A Carpenter
Title
Evp/Coo
Phone
(954) 265-2995

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Durable Medical Equipment & Medical Supplies 332B00000X 4316 FL Primary

Addresses

Primary practice location

12235 Pines Blvd Ste 1101
Pembroke Pines, FL 33026-4119

Mailing address

PO Box 538500
Atlanta, GA 30353-8500
Phone (954) 844-3030

Other names 1

  • Memorial Cancer Institute Center for Body, Mind and Spirit Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930006555 FL DME Supplier - Hospital 8123927373 Practice locations: Pembroke Pines, FL

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Specialty Cen58 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

5830 Coral Ridge Dr
Ste 211
Coral Springs, FL 33076

1131 N 35th Ave
Fl 2
Hollywood, FL 33021
Phone (954) 265-6319

1150 N 35th Ave
#170
Hollywood, FL 33021

1150 N 35th Ave
Ste 331
Hollywood, FL 33021

3700 Johnson St
Hollywood, FL 33021
Phone (954) 265-2550

3700 Johnson St
Ste 170
Hollywood, FL 33021

12235 Pines Blvd
Rm 1101
Pembroke Pines, FL 33026

12235 Pines Blvd
Ste 1101
Pembroke Pines, FL 33026
Phone (954) 844-7199

603 N Flamingo Rd
Ste 159
Pembroke Pines, FL 33028
Phone (305) 751-4964

Ownership & related parties

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Memorial Hospital MiramarMiramar, FL, CCN 100285 Hospital Operational/Managerial Control
Other		 Mar 23, 2005
Mar 23, 2005
Memorial Regional HospitalHollywood, FL, CCN 100038 Hospital Operational/Managerial Control Jul 1, 1966
Memorial Rehabilitation InstituteHollywood, FL, CCN 10T038 Hospital Operational/Managerial Control Jun 1, 2017
Memorial Regional HospitalHollywood, FL, CCN 10S038 Hospital Operational/Managerial Control
Other		 Jan 1, 2016
Jan 1, 2020
Memorial Hospital WestPembroke Pines, FL, CCN 100281 Hospital Operational/Managerial Control
Other		 Feb 18, 2022
Oct 14, 2013
Memorial Hospital PembrokePembroke Pines, FL, CCN 100230 Hospital Operational/Managerial Control
Other		 Apr 1, 2020
Apr 1, 2020
Memorial Manor Nursing HomePembroke Pines, FL, CCN 105668 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jun 3, 1989
Jun 3, 1989

Practitioners & affiliated clinicians

Practitioners 11

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": "1218412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1225284292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 538500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303538500",
            "telephone_number": "954-844-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12235 PINES BLVD STE 1101",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330264119",
            "telephone_number": "954-844-7199",
            "fax_number": "954-844-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BROWARD HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-11",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "LEAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EVP/COO",
        "authorized_official_telephone_number": "954-265-2995"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "4316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Cancer Institute Center for Body, Mind and Spirit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.