NPIMap

Organization Active NPI

South Broward Hospital District

  • Surgical Physician Assistant
  • Hollywood, FL
National Provider Identifier
1285641209
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
SOUTH BROWARD HOSPITAL DISTRICT
Practice address
3501 Johnson Street
Hollywood, FL 33021
Phone
(954) 987-2000
Fax
(954) 985-5691
NPI assigned
Aug 2, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mario Salceda-Cruz
Title
Administrator
Phone
(954) 265-4684

Other NPIs on the same Medicare enrollment 17

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

Practitioners 32

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

View all 32

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

Locations

5830 Coral Ridge Dr
Ste 207
Coral Springs, FL 33076
Phone (954) 501-0505

1150 N 35th Ave
Hollywood, FL 33021
Phone (954) 967-9400

1150 N 35th Ave
Ste 130
Hollywood, FL 33021
Phone (954) 265-7700

4150 Pembroke Rd
Hollywood, FL 33021

1951 SW 172nd Ave
Ste 405
Miramar, FL 33029
Phone (954) 265-7700

12781 Miramar Pkwy
#1202
Miramar, FL 33027

1971 SW 172nd Ave
Fl 2
Miramar, FL 33029
Phone (954) 265-6333

1971 SW 172nd Ave
Ste 300
Miramar, FL 33029
Phone (954) 265-1616

7031 Taft St
Pembroke Pines, FL 33024
Phone (954) 276-0820

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X Primary

Addresses

NPPES NPI Registry

Primary practice location

3501 Johnson Street
Hollywood, FL 33021

Mailing address

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

Other names 1

NPPES NPI Registry
  • Memorial Division of Professional Services 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 Feb 16, 2017.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1285641209",
    "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": "3501 JOHNSON STREET",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-987-2000",
            "fax_number": "954-985-5691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BROWARD HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "SALCEDA-CRUZ",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-265-4684"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Division of Professional Services",
            "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 Feb 16, 2017; 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.