NPIMap

Organization Active NPI

South Broward Hospital District

Doing business as Memorial Division of Immunology, Allergy and Pediatric Rheumatology

  • Pediatric Allergy/Immunology Physician
  • Hollywood, FL
National Provider Identifier
1790076115
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
Legal business name
SOUTH BROWARD HOSPITAL DISTRICT
Doing business as
Memorial Division of Immunology, Allergy and Pediatric Rheumatology
Practice address
1131 N 35TH Ave Ste 220
Hollywood, FL 33021-5403
Phone
(954) 265-3030
Fax
(954) 265-3065
NPI assigned
Apr 20, 2011
Last updated
Jan 6, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH BROWARD HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Allergy/Immunology Physician 2080P0201X NU Primary

Addresses

Primary practice location

1131 N 35TH Ave Ste 220
Hollywood, FL 33021-5403

Mailing address

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

Other practice location 1

3377 S State Rd 7
Suite 100
Wellington, FL 33449-8082
Phone (561) 341-7000

Other practice location 2

1951 SW 172nd Ave Ste 415
Miramar, FL 33029-5614
Phone (954) 265-3030

Other practice location 3

601 N Flamingo Rd Ste 403
Pembroke Pines, FL 33028-1011
Phone (954) 265-3030

Other practice location 4

1150 N 35th Ave Ste 490
Hollywood, FL 33021-5423
Phone (954) 265-3437

Other practice location 5

900 Glades Rd Ste 501
Boca Raton, FL 33431-6421
Phone (954) 265-3030

Other names 1

  • Memorial Division of Immunology, Allergy and Pediatric Rheumatology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130604000337 FL Part B Supplier - Clinic/Group Practice 8123927373 Receives reassigned benefits from 9 practitioners
Practice locations: Hollywood, FL; Wellington, FL; Pembroke Pines, FL; Boca Raton, FL; Miramar, FL

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hosp Div Ortho58 organizations share this tax ID, including this one
Part of
Memorial Hosp Div Ortho

Organizations with this tax ID in the same state 18

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

View all 18

Locations

20803 Biscayne Blvd
Ste 20
Aventura, FL 33180

900 Glades Rd
Ste 501
Boca Raton, FL 33431
Phone (954) 265-4475

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

Networks

  • HealthSun Health Plans Network

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Memorial Hospital MiramarMiramar, FL, CCN 100285 Hospital Operational/Managerial Control
Other		 Mar 23, 2005
Mar 23, 2005
Memorial Regional HospitalHollywood, FL, CCN 100038 Hospital Operational/Managerial Control Jul 1, 1966
Memorial Rehabilitation InstituteHollywood, FL, CCN 10T038 Hospital Operational/Managerial Control Jun 1, 2017
Memorial Regional HospitalHollywood, FL, CCN 10S038 Hospital Operational/Managerial Control
Other		 Jan 1, 2016
Jan 1, 2020
Memorial Hospital WestPembroke Pines, FL, CCN 100281 Hospital Operational/Managerial Control
Other		 Feb 18, 2022
Oct 14, 2013
Memorial Hospital PembrokePembroke Pines, FL, CCN 100230 Hospital Operational/Managerial Control
Other		 Apr 1, 2020
Apr 1, 2020
Memorial Manor Nursing HomePembroke Pines, FL, CCN 105668 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jun 3, 1989
Jun 3, 1989

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767657600000",
    "number": "1790076115",
    "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": "1131 N 35TH AVE STE 220",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215403",
            "telephone_number": "954-265-3030",
            "fax_number": "954-265-3065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3377 S State Rd 7",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Wellington",
            "state": "FL",
            "postal_code": "334498082",
            "country_code": "US",
            "telephone_number": "561-341-7000",
            "fax_number": "561-784-7098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1951 SW 172nd Ave Ste 415",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330295614",
            "country_code": "US",
            "telephone_number": "954-265-3030",
            "fax_number": "954-265-3065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 N Flamingo Rd Ste 403",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281011",
            "country_code": "US",
            "telephone_number": "954-265-3030",
            "fax_number": "954-276-0165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1150 N 35th Ave Ste 490",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330215423",
            "country_code": "US",
            "telephone_number": "954-265-3437",
            "fax_number": "954-983-5052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Glades Rd Ste 501",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334316421",
            "country_code": "US",
            "telephone_number": "954-265-3030",
            "fax_number": "954-265-3065",
            "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": "2011-04-20",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "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": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Division of Immunology, Allergy and Pediatric Rheumatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.