North Broward Hospital District
Organization Active NPI Cardiovascular Disease Physician · Fort Lauderdale, FL
NPI 1306874342 · NPPES record last updated Oct 16, 2024
Key facts
- NPI
- 1306874342
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- Legal business name
- NORTH BROWARD HOSPITAL DISTRICT
- Practice address
- 1601 S Andrews Ave FL 3
Fort Lauderdale, FL 33316-2509 - Phone
- (954) 320-3380
- Fax
- (954) 320-3371
- NPI assigned
- Jun 29, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- NORTH BROWARD HOSPITAL DISTRICT
Authorized official
- Name
- Alisa Bert
- Title
- Interim Cfo
- Phone
- (954) 847-4117
Corporate family (same tax ID) 24
Practitioners 3
-
Debora Duro, MD, MS
-
Pablo A Rengifo-Moreno, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040405001860 | FL | Part B Supplier - Clinic/Group Practice | 3577472422 |
Receives reassigned benefits from 251 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Robert L Odell MD
- Part of
- Robert L Odell MD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | Yes | ||
| Vascular Surgery Physician |
2086S0129X |
Addresses
Primary practice location
1601 S Andrews Ave FL 3
Fort Lauderdale, FL 33316-2509
Mailing address
1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3750
Phone (954) 320-3380
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00020 | Other | FL | BCBS |
| 253794047 | Medicaid | FL |
Other names
- BH Physicians Main
- BHPG M 1601 CAR
Other providers in Fort Lauderdale, FL
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
All providers in Fort Lauderdale, FL · Cardiovascular Disease Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.