SOUTH BROWARD HOSPITAL DISTRICT (NPI# 1285641209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285641209 |
| Entity Type | Organization |
| Organization Name | SOUTH BROWARD HOSPITAL DISTRICT |
| Other Organization Name | MEMORIAL DIVISION OF PROFESSIONAL SERVICES |
| Practice Address |
3501 Johnson Street Hollywood FL 33021 |
| Mailing Address |
2900 Corporate Way Door D Miramar FL 33025-3925 |
| Practice Telephone | 9549872000 |
| Practice Fax Number | 9549855691 |
| Mailing Telephone | 9542765685 |
| Mailing Fax Number | 9549857074 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2017-02-16 |
| Authorized Official Name | MARIO SALCEDA-CRUZ (ADMINISTRATOR) |
| Authorized Official Telephone | 9542654684 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Memorial Division of Professional Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386297513 | South Broward Hospital District | Clinic/Center | 7369 Sheridan St Ste 302b, Hollywood, FL 33024-2776 | 2019-07-17 |
| 1598321051 | South Broward Hospital District | Internal Medicine | 7369 Sheridan St Ste 302, Hollywood, FL 33024-2776 | 2019-05-10 |
| 1558850149 | South Broward Hospital District | Pediatrics | 105 Joe Dimaggio Dr, Pediatric Heart Station, Hollywood, FL 33021 | 2018-05-09 |
| 1821538505 | South Broward Hospital District | Pharmacy | 9571 Premier Pkwy, Miramar, FL 33025-3206 | 2017-03-01 |
| 1245656792 | South Broward Hospital District | Clinical Neuropsychologist | 3600 Washington St Ste 1005, Hollywood, FL 33021-8216 | 2014-03-07 |
| 1043656614 | South Broward Hospital District | Pharmacy | 9579 Premier Pkwy, Miramar, FL 33025-3206 | 2013-05-22 |
| 1205270907 | South Broward Hospital District | Neurological Surgery | 4650 Sheridan St, Suite 150, Hollywood, FL 33021 | 2013-04-24 |
| 1780027870 | South Broward Hospital District | Physical Medicine & Rehabilitation | 4651 Sheridan Street, Suite 150, Hollywood, FL 33024 | 2013-04-09 |
| 1790076115 | South Broward Hospital District | Pediatrics | 1131 N 35th Ave Ste 220, Hollywood, FL 33021-5403 | 2011-04-20 |
| 1790867133 | South Broward Hospital District | General Acute Care Hospital | 2900 Corporate Way, Miramar, FL 33025-3925 | 2006-10-19 |
| Street Address |
3501 JOHNSON STREET |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477559961 | Maria C Barrientos | Nurse Practitioner | 3501 Johnson Street, Third Floor, Hollywood, FL 33021-5421 | 2005-06-21 |
| 1790266781 | Crystal Lynn Ayala | Nurse Practitioner | 3501 Johnson Street, Hollywood, FL 33021 | 2018-08-27 |
| 1679088868 | Melissa Chamberlain | Nurse Practitioner | 3501 Johnson Street, Third Floor, Hollywood, FL 33021-5421 | 2017-12-09 |
| 1912450610 | Amy Christian Deramo | Nurse Practitioner | 3501 Johnson Street, Hollywood, FL 33021 | 2016-07-28 |
| 1275939282 | Doreen Grant | Nurse Practitioner | 3501 Johnson Street, Hollywood, FL 33021 | 2014-11-18 |
| 1053728659 | Elizabeth Rena Marshall | Social Worker | 3501 Johnson Street, Radiation Oncology - Oncology Social Worker, Hollywood, FL 33021 | 2014-07-15 |
| 1942622048 | Jennifer Santoro | Nurse Anesthetist, Certified Registered | 3501 Johnson Street, Hollywood, FL 33021 | 2014-01-09 |
| 1407283617 | Sara Patricia Brusco | Anesthesiologist Assistant | 3501 Johnson Street, Hollywood, FL 33021-5421 | 2013-10-02 |
| 1124398078 | Alison Davis-lavandosky | Physician Assistant | 3501 Johnson Street, Hollywood, FL 33027 | 2012-01-10 |
| 1467757807 | Johanna M. Forero-moylan | Nurse Anesthetist, Certified Registered | 3501 Johnson Street, Hollywood, FL 33021 | 2011-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548893894 | Seminole Tribe of Florida Health Department | Pharmacy | 111 W. Coral Way, Hollywood, FL 33021 | 2020-02-14 |
| 1437714086 | Emilia Roxana Gucciardo | Physician Assistant | 4510 Sheridan Street, Attn: William Pepe, Hollywood, FL 33021 | 2019-05-08 |
| 1649763673 | Sabrina Shoba Mathura | Behavior Technician | 4400 Madison St, Hollywood, FL 33021 | 2018-06-13 |
| 1558850149 | South Broward Hospital District | Pediatrics | 105 Joe Dimaggio Dr, Pediatric Heart Station, Hollywood, FL 33021 | 2018-05-09 |
| 1942798368 | Kyndra Monique Liburd | Student in an Organized Health Care Education/Training Program | Attn: Pediatric Residency Program, 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2018-05-01 |
| 1992292106 | Madeleine Mariela Reyes | Nurse Practitioner | 5010 Hollywood Boulevard #100-b, Hollywood, FL 33021 | 2018-04-13 |
| 1487168233 | Gynecologic Oncology & Urogynecology | Obstetrics & Gynecology | 1150 N 35th Ave Ste 670, Hollywood, FL 33021 | 2017-11-30 |
| 1245743012 | Healix Healthcare Services, LLC | Obstetrics & Gynecology | 3990 Sheridan St Ste 207, Hollywood, FL 33021 | 2017-11-14 |
| 1093233587 | Benjamin Laborde | Physical Therapy Assistant | 4200 Washington Street, Hollywood, FL 33021 | 2017-09-05 |
| 1477079358 | Tt Trans, LLC | Non-emergency Medical Transport (VAN) | 3550 Washington Street, 502, Hollywood, FL 33021 | 2017-08-22 |
| Find all providers in zip 33021 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306120746 | Odalis Castellon | Physician Assistant | 3449 Johnson Street, Hollywood, FL 33021 | 2011-10-04 |
| 1700992559 | Magdalena Marie Gonzalez | Physician Assistant | 1150 N 35th Ave Ste 600, Hollywood, FL 33021 | 2006-08-22 |
| 1003381526 | Andrea Lobue | Physician Assistant | 4700 Sheridan St Ste H, Hollywood, FL 33021-3416 | 2018-10-11 |
| 1699160705 | Melissa Lee Chapman-leccesse | Physician Assistant | 1150 N 35th Ave, Suite 345, Hollywood, FL 33021-5424 | 2015-04-06 |
| 1225420441 | Shari Selesky | Physician Assistant | 1150 N 35th Avenue, Ste 600, Hollywood, FL 33021 | 2015-02-25 |
| 1790087856 | Blue Lion Medical | Physician Assistant | 3600 Washington St, Hollywood, FL 33021-8216 | 2010-11-23 |
| 1831418458 | Armaal Rashard Hunter | Physician Assistant | 1150 N 35th Avenue, Suite 440, Hollywood, FL 33021-5430 | 2010-05-21 |
| 1467538462 | Krystal M Buckland | Physician Assistant | 1150 N 35th Ave, Ste 345, Hollywood, FL 33021 | 2006-10-31 |
| 1518052885 | Christina Marie Callan | Physician Assistant | 1150 N 35th Ave, Suite 345, Hollywood, FL 33021 | 2006-10-04 |
| 1245346063 | Krysten Riordan | Physician Assistant | 4440 Sheridan St, Hollywood, FL 33021-3535 | 2006-08-22 |
| Find all providers in HOLLYWOOD | ||||
Please comment or provide details below to improve the information on SOUTH BROWARD HOSPITAL DISTRICT.
| 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.