NPIMap

Organization Active NPI

South Broward Hospital District

Doing business as Memorial Division of Palliative Medicine

  • Pain Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1275977951
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
SOUTH BROWARD HOSPITAL DISTRICT
Doing business as
Memorial Division of Palliative Medicine
Practice address
603 N Flamingo Rd Ste 151
Pembroke Pines, FL 33028-1021
Phone
(954) 265-4325
Fax
(954) 276-0744
NPI assigned
Apr 24, 2013
Organization subpart
Yes
Parent organization
SOUTH BROWARD HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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

Authorized official

Name
Nina Beauchesne
Title
Executive Vice President
Phone
(954) 265-3451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

603 N Flamingo Rd Ste 151
Pembroke Pines, FL 33028-1021

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Other practice location 1

2900 Corporate Way
Miramar, FL 33025
Phone (954) 276-5572

Other practice location 2

1150 N 35th Ave Ste 330
Hollywood, FL 33021-5488
Phone (954) 265-4325

Other identifiers 1

IdentifierTypeStateIssuer
038184549MedicaidFL

Other names 1

  • Memorial Division of Palliative Medicine Doing business as

National Provider Directory

National Provider Directory
Part of
Memorial Hosp Div Ortho

NPI Registry JSON

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532304000000",
    "number": "1275977951",
    "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": "603 N FLAMINGO RD STE 151",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281021",
            "telephone_number": "954-265-4325",
            "fax_number": "954-276-0744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 CORPORATE WAY",
            "address_purpose": "LOCATION",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "33025",
            "country_code": "US",
            "telephone_number": "954-276-5572",
            "fax_number": "954-985-7074",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1150 N 35th Ave Ste 330",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330215488",
            "country_code": "US",
            "telephone_number": "954-265-4325",
            "fax_number": "954-276-0744",
            "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": "2013-04-24",
        "last_updated": "2018-07-23",
        "status": "A",
        "authorized_official_last_name": "BEAUCHESNE",
        "authorized_official_first_name": "NINA",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "954-265-3451"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038184549",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Division of Palliative Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; 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.