NPIMap

Organization Active NPI

South Broward Hospital District

  • Specialist
  • Hollywood, FL
National Provider Identifier
1265448286
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SOUTH BROWARD HOSPITAL DISTRICT
Practice address
3700 Johnson St
Hollywood, FL 33021-6031
Phone
(954) 987-2020
Fax
(954) 965-6390
NPI assigned
Jul 31, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Leah Carpenter
Title
Executive Vice President
Phone
(954) 265-2995

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20040107000217 FL Part B Supplier - Clinic/Group Practice 8123927373 Receives reassigned benefits from 490 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pembroke Pines, FL; Miramar, FL; Hollywood, FL; Wellington, FL; Weston, FL; Aventura, FL; Boca Raton, FL; Coral Springs, FL…

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hospital (58 organizations share this tax ID)

Locations

1971 SW 172nd Ave
Ste 500
Miramar, FL 33029
Phone (954) 265-3437

801 N Flamingo Rd
#11
Pembroke Pines, FL 33028

603 N Flamingo Rd
Ste 157
Pembroke Pines, FL 33028
Phone (954) 276-1330

603 N Flamingo Rd
Ste 11
Pembroke Pines, FL 33028

603 N Flamingo Rd
Pembroke Pines, FL 33028
Phone (954) 844-5000

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

NPPES NPI Registry

Primary practice location

3700 Johnson St
Hollywood, FL 33021-6031

Mailing address

PO Box 862233
Orlando, FL 32886-2233
Phone (954) 987-2020

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
038184516MedicaidFL

Other names 1

NPPES NPI Registry
  • Memorial Division of Breast Oncology Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 12, 2021.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1265448286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 862233",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328862233",
            "telephone_number": "954-987-2020",
            "fax_number": "954-965-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216031",
            "telephone_number": "954-987-2020",
            "fax_number": "954-965-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BROWARD HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "LEAH",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "954-265-2995"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038184516",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Division of Breast Oncology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Division of Breast Oncology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.