Active NPI
Hollywood Pavilion LLC
- Psychiatric Hospital
- Hollywood, FL
National Provider Identifier
1326027723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital
- License
- 4361
- Legal business name
- HOLLYWOOD PAVILION LLC
- Practice address
- 1201 N 37TH Ave
Hollywood, FL 33021-5414 - Phone
- (954) 962-1355
- Fax
- (954) 981-5520
- NPI assigned
- Jan 13, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Karen Kallen-Zury
- Title
- Ceo
- Phone
- (954) 962-1355
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | 4361 | FL | Primary |
Addresses
Primary practice location
1201 N 37TH Ave
Hollywood, FL 33021-5414
Mailing address
1201 N 37TH Ave
Hollywood, FL 33021-5414
Phone (954) 962-1355
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E80 | Other | FL | BLUE CROSS PROVIDER NUMBE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Hospital certification: CCN 104015
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- HOLLYWOOD PAVILION
- Certification status
- Terminated Involuntary: failure to meet agreement, May 3, 2013
- Provider type (POS)
- Hospital – Psychiatric
- Participating since
- Apr 5, 1973
- Last certification
- Dec 9, 2009
- Beds
- 46
- Ownership / control type
- Private (for profit)
- Most recent change of ownership
- May 1, 2001 (1 total)
- Facility address
- 1201 N 37TH Ave
Hollywood, FL 33021
National Provider Directory
National Provider DirectoryLocations
3801 Hollywood Blvd
Ste 300
Hollywood, FL 33021
Phone (954) 962-1355
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1326027723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 N 37TH AVE",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330215414",
"telephone_number": "954-962-1355",
"fax_number": "954-981-5520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 N 37TH AVE",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330215414",
"telephone_number": "954-962-1355",
"fax_number": "954-981-5520"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLLYWOOD PAVILION LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-13",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "KALLEN-ZURY",
"authorized_official_first_name": "KAREN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "954-962-1355"
},
"taxonomies": [
{
"code": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": "FL",
"license": "4361",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER NUMBE",
"identifier": "E80",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
- Hollywood Mobile Imaging Inc
- Hollywood Oral Surgery, PLLC
- Hollywood Orthopedics
- Hollywood Pain Relief Dispensary
- Hollywood Paradise Residence Inc
- Hollywood Pediatrics, P.a.
- Hollywood Perfect Smile PA
- Hollywood Psychology Center Inc.
- Hollywood PT Associates, Inc.
- Hollywood Regional Opco (Hollywood Regional Surgery Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.