NPIMap

Organization Active NPI

South Broward Hospital District

Doing business as Memorial Division of Otolaryngology

  • Otolaryngology Physician
  • Hollywood, FL
National Provider Identifier
1457798704
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
SOUTH BROWARD HOSPITAL DISTRICT
Doing business as
Memorial Division of Otolaryngology
Practice address
1150 N 35TH Ave Ste 540
Hollywood, FL 33021
Phone
(954) 265-2750
Fax
(954) 893-6323
NPI assigned
May 28, 2013
Last updated
Sep 29, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH BROWARD HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Authorized official

Name
Mario Salceda-Cruz
Title
Chief Operating Officer MPG
Phone
(954) 276-9312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

1150 N 35TH Ave Ste 540
Hollywood, FL 33021

Mailing address

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

Other practice location 1

601 N Flamingo Rd Ste 307
Pembroke Pines, FL 33028-1010
Phone (954) 265-1700

Other practice location 2

1150 N 35th Ave Ste 670
Hollywood, FL 33021-5435
Phone (954) 265-1700

Other practice location 3

603 N Flamingo Rd Ste 151
Pembroke Pines, FL 33028-1021
Phone (954) 265-2750

Other names 1

  • Memorial Division of Otolaryngology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131204000401 FL Part B Supplier - Clinic/Group Practice 8123927373 Receives reassigned benefits from 13 practitioners
Practice locations: Hollywood, FL; Miramar, FL; Pembroke Pines, FL

National Provider Directory

National Provider Directory
Part of
Eddy H Carrillo MD

Networks

  • HealthSun Health Plans Network

Ownership & related parties

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Memorial Hospital MiramarMiramar, FL, CCN 100285 Hospital Operational/Managerial Control
Other		 Mar 23, 2005
Mar 23, 2005
Memorial Regional HospitalHollywood, FL, CCN 100038 Hospital Operational/Managerial Control Jul 1, 1966
Memorial Rehabilitation InstituteHollywood, FL, CCN 10T038 Hospital Operational/Managerial Control Jun 1, 2017
Memorial Regional HospitalHollywood, FL, CCN 10S038 Hospital Operational/Managerial Control
Other		 Jan 1, 2016
Jan 1, 2020
Memorial Hospital WestPembroke Pines, FL, CCN 100281 Hospital Operational/Managerial Control
Other		 Feb 18, 2022
Oct 14, 2013
Memorial Hospital PembrokePembroke Pines, FL, CCN 100230 Hospital Operational/Managerial Control
Other		 Apr 1, 2020
Apr 1, 2020
Memorial Manor Nursing HomePembroke Pines, FL, CCN 105668 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jun 3, 1989
Jun 3, 1989

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790640000000",
    "number": "1457798704",
    "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 STE 540",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-265-2750",
            "fax_number": "954-893-6323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 N Flamingo Rd Ste 307",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281010",
            "country_code": "US",
            "telephone_number": "954-265-1700",
            "fax_number": "954-276-0623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1150 N 35th Ave Ste 670",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330215435",
            "country_code": "US",
            "telephone_number": "954-265-1700",
            "fax_number": "954-276-0623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "603 N Flamingo Rd Ste 151",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281021",
            "country_code": "US",
            "telephone_number": "954-265-2750",
            "fax_number": "954-276-0217",
            "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": "2013-05-28",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A",
        "authorized_official_last_name": "SALCEDA-CRUZ",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER MPG",
        "authorized_official_telephone_number": "954-276-9312"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Division of Otolaryngology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Division of Otolaryngology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.