SOUTH BROWARD HOSPITAL DISTRICT (NPI# 1558850149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558850149 |
| Entity Type | Organization |
| Organization Name | SOUTH BROWARD HOSPITAL DISTRICT |
| Other Organization Name | MEMORIAL DIVISION OF PEDIATRIC ADVANCED HEART FAILURE |
| Practice Address |
105 Joe Dimaggio Dr Pediatric Heart Station Hollywood FL 33021 |
| Mailing Address |
2900 Corporate Way Door D Miramar FL 33025-3925 |
| Practice Telephone | 9542653437 |
| Practice Fax Number | 9542653731 |
| Mailing Telephone | 9542765685 |
| Mailing Fax Number | 9549857074 |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2020-03-11 |
| Authorized Official Name | NINA BEAUCHESNE (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Telephone | 9542653451 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTH BROWARD HOSPITAL DISTRICT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Memorial Division of Pediatric Advanced Heart Failure | Doing Business As Name - Organization |
| Memorial Division of Pediatric Advanced Heart Failure Transplant | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1150 N 35th Ave Ste 490, Hollywood, FL 330215423 | 9542653437 | 9542653731 |
| 3377 S State Rd 7, Suite 100, Wellington, FL 33449 | 5613417000 | 5617847098 |
| 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 |
| 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 |
| 1407865520 | South Broward Hospital District | Orthopaedic Surgery | 1150 N. 35th Avenue, Suite 345, Hollywood, FL 33021-5424 | 2006-08-07 |
| Street Address |
105 JOE DIMAGGIO DR PEDIATRIC HEART STATION |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021 |
| 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 |
| 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 |
| 1962922864 | Mildred Abraham Leggett | Behavior Technician | 5821 Garfield Street, Hollywood, FL 33021 | 2017-06-21 |
| Find all providers in zip 33021 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578534418 | Kaimal Anitha Jayakumar | Pediatrics | 1150 N 35th Ave Ste 490, Hollywood, FL 33021-5423 | 2006-01-30 |
| 1316943376 | Bibhuti Das | Pediatrics | 1150 N 35th Ave Ste 575, Hollywood, FL 33021 | 2005-06-24 |
| 1588153175 | South Broward Hospital District | Pediatrics | 1150 N 35th Ave Ste 490, Hollywood, FL 33021 | 2018-05-09 |
| 1003168451 | Jay S. Chandar, Md, Pa | Pediatrics | 3850 Hollywood Blvd, Suite 202, Hollywood, FL 33021-6700 | 2012-10-10 |
| 1366704405 | Laura D'addese | Pediatrics | 1150 N 35th Ave Ste 490, Hollywood, FL 33021-5423 | 2012-06-14 |
| 1811257017 | Svetlana Shugh | Pediatrics | 1150 N 35th Ave Ste 490, Hollywood, FL 33021-5423 | 2012-05-22 |
| 1033478698 | Tarah Joy Popp | Pediatrics | 1150 N 35th Ave Ste 490, Hollywood, FL 33021-5423 | 2012-05-16 |
| 1205101326 | Orhan Usame Kilinc | Pediatrics | 1150 N 35th Ave Ste 490, Hollywood, FL 33021 | 2012-03-22 |
| 1316261183 | Lazaro Eduardo Hernandez | Pediatrics | 1150 N 35th Ave Ste 490, Hollywood, FL 33021-5423 | 2010-03-23 |
| 1073759379 | Ronald Allen Ligon Jr. | Pediatrics | 1150 N 35th Ave Ste 490, Hollywood, FL 33021 | 2008-12-17 |
| Find all providers in HOLLYWOOD | ||||
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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.