NPIMap

Organization Active NPI

South Broward Hospital District

Doing business as Memorial Division of Cancer Institute

  • Hematology (Internal Medicine) Physician
  • Pembroke Pines, FL
National Provider Identifier
1780691865
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
Legal business name
SOUTH BROWARD HOSPITAL DISTRICT
Doing business as
Memorial Division of Cancer Institute
Practice address
12235 Pines Blvd
Pembroke Pines, FL 33026-4119
Phone
(954) 265-4325
Fax
(954) 438-5191
NPI assigned
Aug 2, 2006
Last updated
Jun 25, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH BROWARD HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X Primary
Medical Oncology Physician 207RX0202X

Addresses

Primary practice location

12235 Pines Blvd
Pembroke Pines, FL 33026-4119

Mailing address

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

Other practice location 1

1150 N 35th Ave Ste 330
Hollywood, FL 33021-5488
Phone (954) 276-5603

Other practice location 2

1750 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4611
Phone (954) 265-4325

Other practice location 3

1150 N 35th Ave Ste 170
Hollywood, FL 33021-5424
Phone (954) 265-4325

Other practice location 4

801 N Flamingo Rd Ste 11
Pembroke Pines, FL 33028-1046
Phone (954) 276-5603

Other practice location 5

1951 SW 172nd Ave Ste 313
Miramar, FL 33029-5614
Phone (954) 276-5603

Other practice location 6

1150 N 35th Ave Ste 385
Hollywood, FL 33021-5429
Phone (954) 276-5603

Other names 1

  • Memorial Division of Cancer Institute Doing business as

Medicare participation

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

Enrollment records 1

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…

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory
Part of
Memorial Hosp Div Ortho

Locations

1150 N 35th Ave
Ste 170
Hollywood, FL 33021
Phone (954) 985-1500

1150 N 35th Ave
Ste 385
Hollywood, FL 33021
Phone (954) 276-5603

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 107

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 107

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1780691865",
    "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": "12235 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330264119",
            "telephone_number": "954-265-4325",
            "fax_number": "954-438-5191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 N 35th Ave Ste 330",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330215488",
            "country_code": "US",
            "telephone_number": "954-276-5603",
            "fax_number": "954-981-3872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1750 E Hallandale Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Hallandale Beach",
            "state": "FL",
            "postal_code": "330094611",
            "country_code": "US",
            "telephone_number": "954-265-4325",
            "fax_number": "954-443-4747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1150 N 35th Ave Ste 170",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330215424",
            "country_code": "US",
            "telephone_number": "954-265-4325",
            "fax_number": "954-965-6388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 N Flamingo Rd Ste 11",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281046",
            "country_code": "US",
            "telephone_number": "954-276-5603",
            "fax_number": "954-443-4747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1951 SW 172nd Ave Ste 313",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330295614",
            "country_code": "US",
            "telephone_number": "954-276-5603",
            "fax_number": "954-443-4747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1150 N 35th Ave Ste 385",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330215429",
            "country_code": "US",
            "telephone_number": "954-276-5603",
            "fax_number": "954-981-3872",
            "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": "2006-08-02",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "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": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Division of Cancer Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.