South Broward Hospital District
Organization Active NPI Interventional Cardiology Physician · Hollywood, FL
NPI 1487057519 · NPPES record last updated Feb 24, 2020
Key facts
- NPI
- 1487057519
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Interventional Cardiology Physician 207RI0011X
- Legal business name
- SOUTH BROWARD HOSPITAL DISTRICT
- Practice address
- 1150 N 35TH Ave Ste 605
Hollywood, FL 33021-5431 - Phone
- (954) 265-7900
- Fax
- (954) 276-0271
- NPI assigned
- Oct 3, 2014
- Organization subpart
- Yes
- Parent organization (as reported)
- SOUTH BROWARD HOSPITAL DISTRICT
Authorized official
- Name
- Esther Surujon
- Title
- Cfo MPG & MPC
- Phone
- (954) 265-6677
Other NPIs on the same Medicare enrollment 2
Practitioners 12
-
Alan Ackermann, DO
-
Walif Aji, MD
-
Jennifer Ann Baker, ARNP
-
Holly L. Gaines, MD
-
Alexandra Fatima Hardy, ARNP
-
Lillian Lastra, ARNP
-
Ralph Levy, MD
-
Ruchi Patel Egusquiza, M.D.
-
Ethan Siev, MD
-
Andrea Mead Sykes, ARNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140319001324 | FL | Part B Supplier - Clinic/Group Practice | 8123927373 |
Receives reassigned benefits from 79 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Weston, FL; Pembroke Pines, FL; Hollywood, FL; Hialeah, FL; Aventura, FL; Miramar, FL |
National Provider Directory
- Part of
- Memorial Hospital
Locations
1150 N 35th Ave
Ste 605
Hollywood, FL 33021
Phone (954) 965-2966
603 N Flamingo Rd
Ste 255
Pembroke Pines, FL 33028
Phone (954) 265-1125
Networks
- HealthSun Health Plans Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Cardiology Physician |
207RI0011X | Yes |
Addresses
Primary practice location
1150 N 35TH Ave Ste 605
Hollywood, FL 33021-5431
Mailing address
2900 Corporate Way
MPG Door D
Miramar, FL 33025-3925
Phone (954) 276-5581
Other practice location 1
20803 Biscayne Blvd Ste 204
Aventura, FL 33180-1429
Phone (954) 265-7900
Other practice location 2
603 N Flamingo Rd Ste 255
Pembroke Pines, FL 33028-1013
Phone (954) 265-7900
Other names
- Memorial Division of Interventional Cardiology
Other providers in Hollywood, FL
- South Broward Hospital District
- South Broward Hospital District
- South Broward Hospital District
- South Broward Hospital District
- South Broward Hospital District
- South Broward Hospital District
- South Broward Hospital District
- South Broward Hospital District
- South Broward Hospital District
- South Broward Hospital District
All providers in Hollywood, FL · Interventional Cardiology 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 Feb 24, 2020. 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.