NPIMap

Organization Active NPI

South Broward Hospital District

Doing business as Memorial Division of Pediatric Rehabilitative Medicine

  • Pediatric Rehabilitation Medicine Physician
  • Hollywood, FL
National Provider Identifier
1780027870
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X
Legal business name
SOUTH BROWARD HOSPITAL DISTRICT
Doing business as
Memorial Division of Pediatric Rehabilitative Medicine
Practice address
4651 Sheridan Street
Suite 150
Hollywood, FL 33024
Phone
(954) 265-6331
Fax
(954) 965-6480
NPI assigned
Apr 9, 2013
Last updated
Aug 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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

Authorized official

Name
Nina Beauchesne
Title
Sr. Vice President
Phone
(954) 265-6996

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rehabilitation Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P0010X Primary

Addresses

Primary practice location

4651 Sheridan Street
Suite 150
Hollywood, FL 33024

Mailing address

2900 Corporate Way
MPG Door D
Miramar, FL 33025-3925
Phone (954) 276-5581

Other names 1

  • Memorial Division of Pediatric Rehabilitative Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Specialty Cen58 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Locations

4651 Sheridan St
Ste 150
Pembroke Park, FL 33021
Phone (954) 265-6331

NPI Registry JSON

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408924800000",
    "number": "1780027870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "MPG DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5581",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 SHERIDAN STREET",
            "address_2": "SUITE 150",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33024",
            "telephone_number": "954-265-6331",
            "fax_number": "954-965-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BROWARD HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-09",
        "last_updated": "2014-08-25",
        "status": "A",
        "authorized_official_last_name": "BEAUCHESNE",
        "authorized_official_first_name": "NINA",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT",
        "authorized_official_telephone_number": "954-265-6996"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Division of Pediatric Rehabilitative Medicine",
            "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 Aug 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.