NPIMap

Organization Active NPI

South Broward Hospital District

  • Surgical Oncology Physician
  • Hollywood, FL
National Provider Identifier
1528076452
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
Legal business name
SOUTH BROWARD HOSPITAL DISTRICT
Practice address
1150 N 35TH Ave Ste 170
Hollywood, FL 33021
Phone
(954) 265-4325
Fax
(954) 265-9546
NPI assigned
Aug 4, 2006
Organization subpart
Yes
Parent organization
SOUTH BROWARD HOSPITAL DISTRICTAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Esther Surujon
Title
Cfo MPG, MPC & Ucc
Phone
(954) 265-6677

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20040107000217 FL Part B Supplier - Clinic/Group Practice 8123927373 Receives reassigned benefits from 490 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pembroke Pines, FL; Miramar, FL; Hollywood, FL; Wellington, FL; Weston, FL; Aventura, FL; Boca Raton, FL; Coral Springs, FL…

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hospital (58 organizations share this tax ID)
Part of
Memorial Hospital

Locations

1951 SW 172nd Ave
Ste 313
Miramar, FL 33029
Phone (954) 276-5603

Networks

  • HealthSun Health Plans Network

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086X0206X Primary

Addresses

NPPES NPI Registry

Primary practice location

1150 N 35TH Ave Ste 170
Hollywood, FL 33021

Mailing address

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

Other practice location 1

1951 SW 172nd Ave Ste 313
Miramar, FL 33029-5614
Phone (954) 265-4325

Other practice location 2

12235 Pines Blvd
Pembroke Pines, FL 33026-4119
Phone (954) 265-4325

Other names 1

NPPES NPI Registry
  • Memorial Division of Breast Surgical Oncology Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 22, 2024.

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1528076452",
    "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 170",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-265-4325",
            "fax_number": "954-265-9546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1951 SW 172nd Ave Ste 313",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330295614",
            "country_code": "US",
            "telephone_number": "954-265-4325",
            "fax_number": "954-443-4747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12235 Pines Blvd",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330264119",
            "country_code": "US",
            "telephone_number": "954-265-4325",
            "fax_number": "954-443-4747",
            "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": "2006-08-04",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "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": "2086X0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Division of Breast Surgical Oncology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Division of Breast Surgical Oncology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.