SOUTH BROWARD HOSPITAL DISTRICT (NPI# 1407865520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407865520 |
| Entity Type | Organization |
| Organization Name | SOUTH BROWARD HOSPITAL DISTRICT |
| Other Organization Name | MEMORIAL DIVISION OF PEDIATRIC ORTHOPEDICS |
| Practice Address |
1150 N. 35th Avenue Suite 345 Hollywood FL 33021-5424 |
| Mailing Address |
2900 Corporate Way Door D Miramar FL 33025-3925 |
| Practice Telephone | 9542656300 |
| Practice Fax Number | 9549613600 |
| Mailing Telephone | 9542765644 |
| Mailing Fax Number | 9542760668 |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2016-05-25 |
| Authorized Official Name | MARIO SALCEDA-CRUZ (MEMORIAL PHYSICIAN GROUP ADMINISTRA) |
| Authorized Official Telephone | 9542654684 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTH BROWARD HOSPITAL DISTRICT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 174400000X | Specialist | Other Service Providers | ||
| Y | 207XP3100X |
Orthopaedic Surgery Specialization: Pediatric Orthopaedic Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 038184505 | 05 |
| Other Name | Type Code |
|---|---|
| Memorial Division of Pediatric Orthopedics | 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 |
1150 N. 35TH AVENUE SUITE 345 |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021-5424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164866646 | John Thomas Connelly IIi | Physician Assistant | 1150 N. 35th Avenue, Suite 490, Hollywood, FL 33021 | 2013-04-26 |
| 1871723528 | Ari Lamet | Internal Medicine | 1150 N. 35th Avenue, Suite 445, Hollywood, FL 33021-5430 | 2009-07-15 |
| 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 | 207XP3100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Pediatric Orthopaedic Surgery |
| An orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones. |
| Notes: Source: American Academy of Pediatrics, www.aap.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356736607 | Michael Dressing | Orthopaedic Surgery | 1150 N 35th Ave Ste 345, Hollywood, FL 33021-5488 | 2015-04-03 |
| 1639430556 | Andrew Sham Gupta | Orthopaedic Surgery | 1150 N 35th Ave Ste 345, Hollywood, FL 33021 | 2012-06-06 |
| 1124237664 | Phillip Eric Greenbarg | Orthopaedic Surgery | 4440 Sheridan St, Hollywood, FL 33021-3535 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447898580 | North Broward Hospital District | Orthopaedic Surgery | 3100 Coral Hills Dr Ste 202, Coral Springs, FL 33065-4139 | 2019-12-19 |
| 1952662355 | Scoliosis & Pediatric Ortho Pa | Orthopaedic Surgery | 6370 N State Road 7, Suite 100, Coconut Creek, FL 33073-3606 | 2012-06-01 |
| 1144422486 | Hallandale Beach Orthopedics, Inc. | Orthopaedic Surgery | 1250 E Hallandale Beach Blvd Ste 700, Hallandale Beach, FL 33009-4641 | 2007-05-31 |
| 1427259076 | Davida Packer | Orthopaedic Surgery | 901 45th St Kimmel Bldg, West Palm Beach, FL 33407-2413 | 2007-05-30 |
| 1124249511 | Jeffrey Alan Crastnopol | Orthopaedic Surgery | 3405 Saddlebrook Ln, Weston, FL 33331-3034 | 2007-05-01 |
| 1386786838 | Pediatric Orthopedics of Southwest Florida | Orthopaedic Surgery | 15821 Hollyfern Court, Fort Myers, FL 33908 | 2007-02-13 |
| 1134290414 | Luis Edgardo Kortright | Orthopaedic Surgery | 4600 N Habana Ave Ste 6, Tampa, FL 33614-7123 | 2006-11-10 |
| 1205862745 | Raymund Woo | Orthopaedic Surgery | 2501 N Orange Ave Ste 514, Orlando, FL 32804-4674 | 2006-06-25 |
| 1568424075 | David Siambanes | Orthopaedic Surgery | 3003 E. Dr. Martin Luther King Jr. Blvd., Mab-3rd Floor, Tampa, FL 33607-6307 | 2006-04-03 |
| 1740282292 | Randolph Cohen | Orthopaedic Surgery | 5830 Coral Ridge Dr Ste 207, Coral Springs, FL 33076 | 2005-08-15 |
| Find all providers with the same taxonomy | ||||
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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.