NPIMap

Organization Active NPI

South Broward Hospital District

Doing business as Memorial Urgent Care Center

  • Urgent Care Clinic/Center
  • Fort Lauderdale, FL
National Provider Identifier
1457899684
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
SOUTH BROWARD HOSPITAL DISTRICT
Doing business as
Memorial Urgent Care Center
Practice address
16620 Sheridan St
Fort Lauderdale, FL 33331-4128
Phone
(954) 265-3451
Fax
(954) 265-7747
NPI assigned
Feb 8, 2017
Organization subpart
Yes
Parent organization
SOUTH BROWARD HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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 Ucc
Phone
(954) 265-6677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

16620 Sheridan St
Fort Lauderdale, FL 33331-4128

Mailing address

2900 Corporate Way
Suite D
Miramar, FL 33025-3925
Phone (954) 276-5572

Other practice location 1

1740 Sheridan St
Hollywood, FL 33020-2275
Phone (954) 276-1565

Other practice location 2

8665 NW 186th St
Hialeah, FL 33015-2553
Phone (305) 682-2626

Other names 1

  • Memorial Urgent Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171207000746 FL Part B Supplier - Clinic/Group Practice 8123927373 Receives reassigned benefits from 25 practitioners
Practice locations: Fort Lauderdale, FL; Hialeah, FL; Hollywood, FL

National Provider Directory

National Provider Directory
Part of
Memorial Hosp Div Ortho

Locations

8665 NW 186th St
Hialeah, FL 33015
Phone (305) 682-2626

8920 Canyon Falls Blvd
Ste 100
Twinsburg, OH 44087
Phone (330) 486-2850

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 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1457899684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "SUITE D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5572",
            "fax_number": "954-985-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16620 SHERIDAN ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333314128",
            "telephone_number": "954-265-3451",
            "fax_number": "954-265-7747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 Sheridan St",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330202275",
            "country_code": "US",
            "telephone_number": "954-276-1565",
            "fax_number": "954-276-1289",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8665 NW 186th St",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330152553",
            "country_code": "US",
            "telephone_number": "305-682-2626",
            "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": "2017-02-08",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "SURUJON",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_title_or_position": "CFO MPG MPC UCC",
        "authorized_official_telephone_number": "954-265-6677"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Urgent Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Urgent Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.