South Broward Hospital District
Organization Active NPI Critical Care Medicine (Internal Medicine) Physician · Hollywood, FL
NPI 1609884154 · NPPES record last updated Mar 13, 2018
Key facts
- NPI
- 1609884154
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician 207RC0200X
- Legal business name
- SOUTH BROWARD HOSPITAL DISTRICT
- Practice address
- 3501 Johnson St
Hollywood, FL 33021-5421 - Phone
- (954) 265-9976
- Fax
- (954) 965-5396
- NPI assigned
- Aug 3, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SOUTH BROWARD HOSPITAL DISTRICT
Authorized official
- Name
- Nina Beauchesne
- Title
- Executive Vice President
- Phone
- (954) 265-3451
Other NPIs on the same Medicare enrollment 17
Practitioners 500
-
Daniel M. Aghion, MD
-
Norman Ajiboye, MD
-
Alvaro Jose Alencar, M.D.
-
Joey-Ann Lamoy Alexander, APRN
-
Susan Alisanski, MD
-
Vanessa C Alleyne, APRN
-
Robert Alterbaum, M.D.
-
Alexsa Alvarado, LCSW
-
Joan Elizabeth Alvaranga, M.D.
-
Shivani Amara, M.D.
-
Fausto Andrade Rodriguez, M.D.
-
Matthew C Avery, MD
-
Jessica Avila, ARNP
-
Carmel Azemar, LCSW
-
Jheanelle R Bailey, ARNP
-
Monica Balfour, APRN
-
Carmen S Ballestas, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
All facility ownership & control disclosures 7
| Facility | Type | Role | Since |
|---|---|---|---|
| Memorial Hospital Miramar |
Hospital | Operational/Managerial Control Other |
Mar 23, 2005 Mar 23, 2005 |
| Memorial Regional Hospital |
Hospital | Operational/Managerial Control | Jul 1, 1966 |
| Memorial Rehabilitation Institute |
Hospital | Operational/Managerial Control | Jun 1, 2017 |
| Memorial Regional Hospital |
Hospital | Operational/Managerial Control Other |
Jan 1, 2016 Jan 1, 2020 |
| Memorial Hospital West |
Hospital | Operational/Managerial Control Other |
Feb 18, 2022 Oct 14, 2013 |
| Memorial Hospital Pembroke |
Hospital | Operational/Managerial Control Other |
Apr 1, 2020 Apr 1, 2020 |
| Memorial Manor Nursing Home |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jun 3, 1989 Jun 3, 1989 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040107000217 | FL | Part B Supplier - Clinic/Group Practice | 8123927373 |
Receives reassigned benefits from 490 practitioners 17 other NPIs on this 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
- Part of
- Memorial Hospital
Networks
- HealthSun Health Plans Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician |
207RC0200X | Yes |
Addresses
Primary practice location
3501 Johnson St
Hollywood, FL 33021-5421
Mailing address
2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 038184526 | Medicaid | FL |
Other names
- Memorial Division of Critical Care
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 · Critical Care Medicine (Internal Medicine) 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 Mar 13, 2018. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.