NORTH BROWARD HOSPITAL DISTRICT (NPI# 1114366580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114366580 |
| Entity Type | Organization |
| Organization Name | NORTH BROWARD HOSPITAL DISTRICT |
| Other Organization Name | BH PHYSICIANS MAIN |
| Practice Address |
1625 Se 3rd Avenue Suite 623 Fort Lauderdale FL 33316-2521 |
| Mailing Address |
1608 Se 3rd Ave Third Floor Pbo Fort Lauderdale FL 33316-2564 |
| Practice Telephone | 9543203322 |
| Practice Fax Number | 9544627410 |
| Mailing Telephone | 9548474273 |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2017-08-09 |
| Authorized Official Name | BEVERLY CAPASSO (INTERIM PRESIDENT/CEO) |
| Authorized Official Telephone | 9544737100 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTH BROWARD HOSPITAL DISTRICT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 253794070 | 05 |
| Other Name | Type Code |
|---|---|
| BH Physicians Main | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881212744 | North Broward Hospital District | Internal Medicine | 817 S University Dr Ste 104, Plantation, FL 33324-3345 | 2020-07-08 |
| 1447898580 | North Broward Hospital District | Orthopaedic Surgery | 3100 Coral Hills Dr Ste 202, Coral Springs, FL 33065-4139 | 2019-12-19 |
| 1417440991 | North Broward Hospital District | Internal Medicine | 1 W Sample Rd Ste 208, Pompano Beach, FL 33064-3547 | 2018-06-11 |
| 1942692298 | North Broward Hospital District | Psychiatry & Neurology | 50 E Sample Road, Suite 200, Pompano Beach, FL 33064-3550 | 2015-02-24 |
| 1063847341 | North Broward Hospital District | Clinic/Center | 2300 N Commerce Pkwy Ste 110, Weston, FL 33326-3255 | 2013-09-05 |
| 1558700849 | North Broward Hospital District | Family Medicine | 3896 N. Federal Highway, Lighthouse Point, FL 33064 | 2013-06-19 |
| 1952740458 | North Broward Hospital District | Internal Medicine | 1811 N Pine Island Rd, Plantation, FL 33322-5207 | 2013-06-18 |
| 1780922716 | North Broward Hospital District | Clinic/Center | 1811 N. Pine Island Road, Plantation, FL 33322 | 2013-01-25 |
| 1558644690 | North Broward Hospital District | Family Medicine | 6333 N Federal Hwy Ste 225, Fort Lauderdale, FL 33308-1913 | 2011-09-26 |
| 1114164282 | North Broward Hospital District | Family Medicine | 1625 Se 3rd Ave Ste 610, Fort Lauderdale, FL 33316-2521 | 2009-01-12 |
| Street Address |
1625 SE 3RD AVENUE SUITE 623 |
| City | FORT LAUDERDALE |
| State | FL |
| Zip Code | 33316-2521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194728964 | Celso Agner | Psychiatry & Neurology | 1625 Se 3rd Avenue, Suite 623, Fort Lauderdale, FL 33316-2521 | 2005-05-24 |
| 1164884235 | North Broward Hospital District | Pediatrics | 1625 Se 3rd Avenue, Suite 635, Fort Lauderdale, FL 33316-2521 | 2016-03-28 |
| 1962561647 | Michelle Grace Binns | Internal Medicine | 1625 Se 3rd Avenue, Suite 400, Fort Lauderdale, FL 33316-2521 | 2006-12-08 |
| 1922051614 | Matthew M Kenick | Physician Assistant | 1625 Se 3rd Avenue, Third Floor, Fort Lauderdale, FL 33316 | 2006-05-17 |
| 1376500645 | Pamela M Sutton | Family Medicine | 1625 Se 3rd Avenue, Suite 525, Fort Lauderdale, FL 33316 | 2006-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064040 | Jonathan David Ortiz | Behavior Technician | 1717 Se 4 Ave, Fort Lauderdale, FL 33316 | 2020-05-15 |
| 1306311626 | Gateway Recovery Center, LLC | Counselor | 1421 Sw 4th Avenue, Suite B, Fort Lauderdale, FL 33316 | 2018-10-13 |
| 1588141626 | Natan Bastoky | Family Medicine | 1600 S Andrews Ave # Gme, Fort Lauderdale, FL 33316 | 2018-07-22 |
| 1104320126 | Kathleen Kanani Graham | Pharmacist | 1401 S. Federal Highway, Ft. Lauderdale, FL 33316 | 2018-03-23 |
| 1093224271 | Lacosta Therapy, LLC | Behavioral Analyst | 412 Se 15 St., #4, Ft. Lauderdale, FL 33316 | 2017-09-20 |
| 1124560370 | Yulia Rybalka | Pharmacist | 217 Se 10th Street, Ft Lauderdale, FL 33316 | 2016-11-04 |
| 1730635376 | Brian Alexander Reyes | Specialist/Technologist | 303 Se 3rd Ave, Ft Lauderdale, FL 33316 | 2016-09-01 |
| 1649726282 | Jennifer Tabares | Specialist/Technologist | 303 Southeast 3rd Av, Fort Lauderdale, FL 33316 | 2016-09-01 |
| 1609236850 | Diane Nicole Shilling | Nurse Practitioner | 1001 South Andrews Avenue, Suite 100, Ft. Lauderdale, FL 33316 | 2016-03-01 |
| 1396113239 | Victoria Rosado | Adult Companion | 150 Se 12th Street, 401(b), Fort Lauderdale, FL 33316 | 2015-09-09 |
| Find all providers in zip 33316 | ||||
| Taxonomy Code | 2084V0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Vascular Neurology |
| Vascular Neurology is a subspecialty in the evaluation, prevention, treatment and recovery from vascular diseases of the nervous system. This subspecialty includes the diagnosis and treatment of vascular events of arterial or venous origin from a large number of causes that affect the brain or spinal cord such as ischemic stroke, intracranial hemorrhage, spinal cord ischemia and spinal cord hemorrhage. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376745935 | Madhu B Vijayappa | Psychiatry & Neurology | 8984 Sw 64th Ln, Gainesville, FL 32608-8562 | 2007-06-04 |
| 1194837708 | Sally B Zachariah | Psychiatry & Neurology | 10000 Bay Pines Blvd,neurology Section, Vamedical Center,bay Pines, Bay Pines, FL 33744 | 2006-08-31 |
| 1740258110 | Nils H. Mueller-kronast | Psychiatry & Neurology | 8756 Boynton Beach Blvd Ste 2300, Boynton Beach, FL 33472-4439 | 2006-03-10 |
| 1063405975 | Mary June Derbenwick | Psychiatry & Neurology | 350 N Clyde Morris Blvd, Daytona Beach, FL 32114-2733 | 2005-08-25 |
| 1215475025 | Miami Stroke, LLC | Psychiatry & Neurology | 11750 Sw 40th St, Miami, FL 33175-3530 | 2017-02-01 |
| 1972918431 | David Stone | Psychiatry & Neurology | 1700 S Tamiami Trl, Sarasota, FL 34239-3509 | 2014-06-24 |
| 1972897023 | North Broward Hospital District | Psychiatry & Neurology | 201 E Sample Rd, Suite 106, Pompano Beach, FL 33064-3502 | 2011-06-07 |
| 1124337290 | Maxim Vladimirovich Mokin | Psychiatry & Neurology | 2 Tampa General Cir, 3rd Floor, Tampa, FL 33606-3603 | 2010-10-06 |
| 1144547134 | Muhammad Zeeshan Memon | Psychiatry & Neurology | 1611 Nw 12th Ave, Miami, FL 33136 | 2010-04-29 |
| 1497966394 | Ridwan Lin | Psychiatry & Neurology | 201 E Sample Rd, Pompano Beach, FL 33064-3502 | 2007-05-24 |
| Find all providers with the same taxonomy | ||||
| City | FORT LAUDERDALE |
| Zip Code | 33316 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.