SOUTH BROWARD HOSPITAL DISTRICT (NPI# 1114920584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114920584 |
| Entity Type | Organization |
| Organization Name | SOUTH BROWARD HOSPITAL DISTRICT |
| Other Organization Name | MEMORIAL MANOR NURSING HOME |
| Practice Address |
777 S Douglas Rd Pembroke Pines FL 33025-1353 |
| Practice Telephone | 9544311100 |
| Practice Fax Number | 9544434798 |
| Mailing Telephone | 9544311100 |
| Mailing Fax Number | 9544434798 |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2019-01-23 |
| Authorized Official Name | MR. JON HENNEMYRE (ADMINISTRATOR) |
| Authorized Official Telephone | 9542766201 |
| Authorized Official Credential | NHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | SNF1342096 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 020100600 | 05 |
| Other Name | Type Code |
|---|---|
| Memorial Manor | Doing Business As Name - Organization |
| memorial manor nursing home | 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 |
777 S DOUGLAS RD |
| City | PEMBROKE PINES |
| State | FL |
| Zip Code | 33025-1353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609344993 | Michelle Woodbine | Physical Therapy Assistant | 777 S Douglas Rd, Pembroke Pines, FL 33025-1353 | 2018-11-05 |
| 1164904918 | Jasnielka Valdez | Occupational Therapist | 777 S Douglas Rd, Pembroke Pines, FL 33025-1353 | 2018-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538702329 | Ashley V Carter | Nutritionist | 3803 Sw 93rd Ave, Miramar, FL 33025 | 2019-10-24 |
| 1477024305 | Jeff Rocker | Counselor | 10700 City Center Blvd Apt 5245, Pembroke Pines, FL 33025 | 2018-12-17 |
| 1760959779 | Spring Health Inc | In Home Supportive Care | 1799 Sw 82nd Pl, Miramar, FL 33025 | 2018-10-28 |
| 1649763004 | Ann-marie Elizabeth Pryce | Nurse Practitioner | 8942 Sw 19th St, Miramar, FL 33025 | 2018-06-11 |
| 1588154876 | Michelle Angelle Crawford | Behavior Technician | 10630 Washington St Apt 103, Pembroke Pines, FL 33025 | 2018-05-14 |
| 1598267809 | Lydia Rosa Malcolm | Psychologist | 11820 Miramar Pkwy Ste 309, Miramar, FL 33025 | 2018-03-02 |
| 1447760657 | At Talitha Cumi Home Care, Inc. | Homemaker | 3140 Sw 120 Terr, Miramar, FL 33025 | 2017-10-03 |
| 1962924522 | Yenni Celina Cueto | Behavioral Analyst | 720 Sw 111th Ave Apt 303, Pembroke Pines, FL 33025 | 2017-07-14 |
| 1093236713 | Manoucheca Fabienne Phanord | Nurse Practitioner | 11575 City Hall Promenade, #4-150, Miramar, FL 33025 | 2017-07-03 |
| 1659801439 | Desiree Verina Nugent | Family Medicine | 3772 Sw 93rd Ave, Miramar, FL 33025 | 2017-06-14 |
| Find all providers in zip 33025 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912331992 | Communicare Healthcare Services | Skilled Nursing Facility | 9050 Pines Blvd Ste 370, Pembroke Pines, FL 33024-6400 | 2013-08-27 |
| 1861763377 | Maria T Cruz-vargas | Skilled Nursing Facility | 8590 Nw 4th St, Pembroke Pines, FL 33024-6652 | 2012-01-16 |
| 1821410762 | Manish M Patel Md Pa | Skilled Nursing Facility | 1150 N University Dr, Pembroke Pines, FL 33024-5031 | 2014-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306444708 | Center for Comprehensive Services, Inc. | Skilled Nursing Facility | 2411 Clement Rd, Lutz, FL 33549-5552 | 2020-10-16 |
| 1114530227 | Jupiter Rehab and Health Center LLC | Skilled Nursing Facility | 650 Pioneer Rd # 5, Jupiter, FL 33458-8834 | 2020-08-28 |
| 1821601089 | Wellington Rehab and Health Center, LLC | Skilled Nursing Facility | 10330 Nu Vista Ave, Wellington, FL 33414 | 2020-08-27 |
| 1043822349 | Oaks of Kissimmee Operations LLC | Skilled Nursing Facility | 320 N. Mitchell St, Kissimmee, FL 34741-4447 | 2020-08-18 |
| 1720690027 | Brynwood Operations LLC | Skilled Nursing Facility | 1656 S Jefferson St, Monticello, FL 32344-1652 | 2020-08-18 |
| 1326668120 | Key West Nursing Home Propco LLC | Skilled Nursing Facility | 5860 College Road, Key West, FL 33040 | 2020-04-21 |
| 1740800655 | Javara Troupe | Skilled Nursing Facility | 10043 Victory Gallop Loop, Ruskin, FL 33573-6744 | 2020-04-21 |
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1053944116 | Pruitthealth - Southwood, LLC | Skilled Nursing Facility | 2301 Bluff Oak Way, Tallahassee, FL 32311-6161 | 2020-02-18 |
| 1992336895 | Dolphin Pointe Health Care, LLC | Skilled Nursing Facility | 5355 Dolphin Point Rd., Jacksonville, FL 32211 | 2020-01-29 |
| Find all providers with the same taxonomy | ||||
| City | PEMBROKE PINES |
| Zip Code | 33025 |
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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.