NPIMap

Organization Active NPI

North Broward Hospital District

Doing business as Ceb Adult Center

  • Federally Qualified Health Center (FQHC)
  • Fort Lauderdale, FL
National Provider Identifier
1972531945
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTH BROWARD HOSPITAL DISTRICT
Doing business as
Ceb Adult Center
Ceb Pediatric Center
Ceb Prenatal Center
Practice address
200 NW 7TH Ave
Fort Lauderdale, FL 33311
Phone
(954) 759-6600
Fax
(954) 759-6665
NPI assigned
Jun 29, 2006
Last updated
May 27, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH BROWARD HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Authorized official

Name
Alisa Bert
Title
Interim Cfo
Phone
(954) 847-4117

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

200 NW 7TH Ave
Fort Lauderdale, FL 33311

Mailing address

1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3750
Phone (954) 759-6600

Other names 3

  • CEB ADULT CENTER Doing business as
  • CEB PEDIATRIC CENTER Doing business as
  • CEB PRENATAL CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040405001860 FL Part B Supplier - Clinic/Group Practice 3577472422 Receives reassigned benefits from 251 practitioners
This NPI is an additional NPI on the enrollment
O20210728002238 FL Part A Provider - Federally Qualified Health Center (FQHC) 3577472422 3 other NPIs on this enrollment
Practice locations: Fort Lauderdale, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972531945. Details of each certification follow.

Federally qualified health center certification: CCN 681888

Legal name
NORTH BROWARD HOSPITAL DISTRICT
Doing business as
CORA E BRAYNON FAMILY HLTH CTR
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 2021
Last certification
Jul 1, 2021
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Incorporated
Jan 6, 2004 in FL
Enrollment address
200 NW 7TH Ave
Fort Lauderdale, FL 33311-9026

Other NPIs with the same Medicare PAC ID 24

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 24

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Part of
NBHD Imperial Point Med

Locations

6405 N Federal Hwy
Ste 200
Ft Lauderdale, FL 33308
Phone (954) 771-3100

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • HealthSun Health Plans Network

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Stuart M Glassberg Individual Corporate OfficerReimbursement Manager Jun 28, 2010
Nancy Gregoire Individual Corporate OfficerBoard Member Dec 1, 2017
Stacy Angier Individual Corporate OfficerBoard Member Oct 19, 2018
Ray Berry Individual Corporate OfficerBoard Member May 11, 2018
Marie Waugh Individual Corporate OfficerBoard Member Nov 30, 2018
Levi Williams Individual Corporate OfficerBoard Member Apr 2, 2021
Alexander Fernandez Individual Corporate OfficerCfo Dec 23, 2018
Corporate DirectorCfo Dec 13, 2018
Operational/Managerial ControlCfo Dec 23, 2018
Shane Strum Individual Corporate OfficerCeo Mar 29, 2021
Corporate DirectorCeo Mar 29, 2021
Operational/Managerial ControlCeo Mar 29, 2021
Christopher Pernicano Individual Corporate OfficerBoard Member Apr 2, 2021
Jonathan Hage Individual Corporate OfficerBoard Member Apr 2, 2021

All facility ownership & control disclosures 9

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

FacilityTypeRoleSince
Broward Health NorthDeerfield Beach, FL, CCN 100086 Hospital Operational/Managerial Control May 14, 2008
Broward Health Imperial PointFort Lauderdale, FL, CCN 100200 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 1, 1984
Jan 1, 1984
Broward Health Medical Center-Psych UnitFort Lauderdale, FL, CCN 10S039 Hospital Operational/Managerial Control Jul 1, 2007
Broward Health Coral SpringsCoral Springs, FL, CCN 100276 Hospital Operational/Managerial Control (100%) Mar 17, 1987
Broward Health Imperial Point-Psych UnitFort Lauderdale, FL, CCN 10S200 Hospital Operational/Managerial Control (100%) Jul 1, 1984
Broward Health North- Rehab UnitDeerfield Beach, FL, CCN 10T086 Hospital Operational/Managerial Control May 13, 2008
Pompano Adult Primary CarePompano Beach, FL, CCN 101840 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 1993
Oct 1, 1993
Specialty Care CenterFort Lauderdale, FL, CCN 101841 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 1993
Jul 1, 1993
Margate Health CenterMargate, FL, CCN 681892 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 1993
Oct 1, 1993

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1972531945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750",
            "telephone_number": "954-759-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NW 7TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33311",
            "telephone_number": "954-759-6600",
            "fax_number": "954-759-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BROWARD HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH BROWARD HOSPITAL DISTRICT",
        "enumeration_date": "2006-06-29",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "BERT",
        "authorized_official_first_name": "ALISA",
        "authorized_official_title_or_position": "INTERIM CFO",
        "authorized_official_telephone_number": "954-847-4117"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CEB ADULT CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CEB PEDIATRIC CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CEB PRENATAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.