South Broward Hospital District

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

48741 Issued in FL

Legal business name

SOUTH BROWARD HOSPITAL DISTRICT

Doing business as

Memorial Division of Pediatric General Surgery

Practice address

1150 N 35TH Ave
Suite 555
Hollywood, FL 33021-5424

Phone

(954) 265-0072

Fax

(954) 981-0188

NPI assigned

Jan 27, 2010

Last updated

May 21, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTH BROWARD HOSPITAL DISTRICTAs reported in NPPES

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

Authorized official

Name

Esther Surujon

Title

Cfo MPG, MPC and Ucc

Phone

(954) 265-6677

Specialties & licenses 1

Addresses

Other names 1

• Memorial Division of Pediatric General Surgery Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Part of

Pediatric Specialty Cen

Locations

All facility ownership & control disclosures 7

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

Practitioners 18

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.

• Clara Huebra Beguiristain, PA-C

  • Pediatric Surgery Physician
  • Hollywood, FL
  • NPI 1063266385

  Single Specialty

  Medicare reassignment NPD
• Noor M Kassira, MD

  • Pediatric Surgery Physician
  • Hollywood, FL
  • NPI 1366692337
  Medicare reassignment NPD
• Oliver Bennett Lao, MD

  • Pediatric Surgery Physician
  • Hollywood, FL
  • NPI 1821191289
  Medicare reassignment NPD
• Tamar Leah Levene, MD

  • Pediatric Surgery Physician
  • Hollywood, FL
  • NPI 1407030752
  Medicare reassignment NPD
• Moiz Mustafa, M.D.

  • Pediatric Surgery Physician
  • Hollywood, FL
  • NPI 1952421208
  Medicare reassignment NPD
• Holly Leigh Neville, MD

  • Pediatric Surgery Physician
  • Hollywood, FL
  • NPI 1245339969
  Medicare reassignment NPD
• Lisa Parlante Rivas, APRN

  • Family Nurse Practitioner
  • Hollywood, FL
  • NPI 1669909362
  Medicare reassignment NPD
• Joya Michelle Smith, APRN-C

  • Primary Care Nurse Practitioner
  • Tampa, FL
  • NPI 1801388830
  Medicare reassignment NPD
• Elke Ojeda Ulloa, PA-C

  • Physician Assistant
  • Hollywood, FL
  • NPI 1790854545
  Medicare reassignment NPD
• Jill Suzanne Whitehouse, MD

  • Pediatric Surgery Physician
  • Hollywood, FL
  • NPI 1467541557
  Medicare reassignment NPD
• Yasmine Yousef, MD

  • Pediatric Surgery Physician
  • Hollywood, FL
  • NPI 1831930288
  Medicare reassignment NPD
• Yangyang Yu, M.D.

  • Pediatric Surgery Physician
  • Hollywood, FL
  • NPI 1952748972
  Medicare reassignment NPD

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1306177589",
    "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": "1150 N 35TH AVE",
            "address_2": "SUITE 555",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215424",
            "telephone_number": "954-265-0072",
            "fax_number": "954-981-0188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20803 Biscayne Blvd Ste 204-A",
            "address_purpose": "LOCATION",
            "city": "Aventura",
            "state": "FL",
            "postal_code": "331801469",
            "country_code": "US",
            "telephone_number": "954-265-0072",
            "fax_number": "954-981-0188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5830 Coral Ridge Dr Ste 140",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330763388",
            "country_code": "US",
            "telephone_number": "954-265-0072",
            "fax_number": "954-981-0188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3377 N State Rd 7 Suite 100",
            "address_purpose": "LOCATION",
            "city": "Wellington",
            "state": "FL",
            "postal_code": "334498082",
            "country_code": "US",
            "telephone_number": "954-265-0072",
            "fax_number": "954-981-0188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1865 N Corporate Lakes Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "FL",
            "postal_code": "333263273",
            "country_code": "US",
            "telephone_number": "954-265-0072",
            "fax_number": "954-981-0188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1971 SW 172nd Ave Ste 2500",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330295621",
            "country_code": "US",
            "telephone_number": "954-265-0072",
            "fax_number": "954-981-0188",
            "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": "2010-01-27",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "SURUJON",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_title_or_position": "CFO MPG, MPC AND UCC",
        "authorized_official_telephone_number": "954-265-6677"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": "FL",
            "license": "48741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Division of Pediatric General Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Broward Hospital District (Memorial Division of Pediatric Dermatology)
• South Broward Hospital District (Memorial Division of Rehabilitative Psychology)
• South Broward Hospital District (Memorial Division of Breast Oncology)
• South Broward Hospital District (Memorial Division of Radiation Oncology)
• South Broward Hospital District (Memorial Division of Professional Services)
• South Broward Hospital District (Memorial Division of Cardiac Services)
• South Broward Hospital District (Memorial Division of Child/Adolescent Psychiatry)
• South Broward Hospital District (Memorial Division of Cystic Fibrosis)
• South Broward Hospital District (Memorial Division of Infectious Disease)
• South Broward Hospital District (Memorial Division of Vascular Surgery)

• Pediatric Surgery Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Pediatric Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.