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Organization Active NPI

South Broward Hospital District

Doing business as Memorial Division of Advanced Heart Failure

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Hollywood, FL
National Provider Identifier
1962991562
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
Legal business name
SOUTH BROWARD HOSPITAL DISTRICT
Doing business as
Memorial Division of Advanced Heart Failure
Practice address
3501 Johnson St FL 1
Hollywood, FL 33021
Phone
(954) 265-7750
Fax
(954) 276-0280
NPI assigned
May 9, 2018
Last updated
Mar 5, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH BROWARD HOSPITAL DISTIRCTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Authorized official

Name
Esther Surujon
Title
Cfo Memorial Physician Group & MPC
Phone
(954) 265-6677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Heart Failure and Transplant Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0001X Primary

Addresses

Primary practice location

3501 Johnson St FL 1
Hollywood, FL 33021

Mailing address

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

Other practice location 1

1150 N 35th Ave Ste 440
Hollywood, FL 33021-5430
Phone (954) 265-6356

Other practice location 2

1951 SW 172nd Ave Ste 404
Miramar, FL 33029-5614
Phone (954) 265-7550

Other practice location 3

601 N Flamingo Rd Ste 307
Pembroke Pines, FL 33028-1010
Phone (954) 265-7750

Other practice location 4

801 N Flamingo Rd
Pembroke Pines, FL 33028-1019
Phone (954) 265-7900

Other practice location 5

603 N Flamingo Rd Ste 260
Pembroke Pines, FL 33028-1013
Phone (954) 265-7750

Other names 1

  • Memorial Division of Advanced Heart Failure Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190226001221 FL Part B Supplier - Hospital Department(S) 8123927373 Receives reassigned benefits from 37 practitioners
Practice locations: Pembroke Pines, FL; Hollywood, FL; Miramar, FL

National Provider Directory

National Provider Directory
Part of
Eddy H Carrillo MD

Locations

1150 N 35th Ave
Ste 440
Hollywood, FL 33021
Phone (954) 265-6356

801 N Flamingo Rd
Ste 107
Pembroke Pines, FL 33028
Phone (954) 265-7750

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 38

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 38

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1962991562",
    "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": "3501 JOHNSON ST FL 1",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-265-7750",
            "fax_number": "954-276-0280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 N 35th Ave Ste 440",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330215430",
            "country_code": "US",
            "telephone_number": "954-265-6356",
            "fax_number": "954-985-5154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1951 SW 172nd Ave Ste 404",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330295614",
            "country_code": "US",
            "telephone_number": "954-265-7550",
            "fax_number": "954-276-0287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 N Flamingo Rd Ste 307",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281010",
            "country_code": "US",
            "telephone_number": "954-265-7750",
            "fax_number": "954-276-0280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 N Flamingo Rd",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281019",
            "country_code": "US",
            "telephone_number": "954-265-7900",
            "fax_number": "954-844-0839",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "603 N Flamingo Rd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281013",
            "country_code": "US",
            "telephone_number": "954-265-7750",
            "fax_number": "954-276-0280",
            "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 DISTIRCT",
        "enumeration_date": "2018-05-09",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "SURUJON",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_title_or_position": "CFO MEMORIAL PHYSICIAN GROUP & MPC",
        "authorized_official_telephone_number": "954-265-6677"
    },
    "taxonomies": [
        {
            "code": "207RA0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Division of Advanced Heart Failure",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.