SOUTH BROWARD HOSPITAL DISTRICT (NPI# 1366785743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366785743 |
| Entity Type | Organization |
| Organization Name | SOUTH BROWARD HOSPITAL DISTRICT |
| Other Organization Name | MEMORIAL DIVISION OF VASCULAR SURGERY |
| Practice Address |
1150 N 35th Avenue Ste 460 Hollywood FL 33021 |
| Mailing Address |
2900 Corporate Way Door D Miramar FL 33025 |
| Practice Telephone | 9542654664 |
| Practice Fax Number | 9542658373 |
| Mailing Telephone | 9542765685 |
| Mailing Fax Number | 9549857074 |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2020-01-28 |
| 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 | 2086S0129X |
Surgery Specialization: Vascular Surgery |
ME112565 | FL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Memorial Division of Vascular Surgery | Doing Business As Name - Organization |
| Memorial Division of Vascular Surgery | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 601 N Flamingo Rd Ste 409, Pembroke Pines, FL 330281012 | 9548444664 | 9548444669 |
| 2301 N University Dr Ste 211, Pembroke Pines, FL 330243617 | 9548444664 | 9548444669 |
| 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 STE 460 |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679523393 | Patricia Joza | Physician Assistant | 1150 N 35th Avenue, Suite 445 Mark Lamet Md Pa, Hollywood, FL 33021 | 2006-05-11 |
| 1437600848 | Melissa Haydee Diaz | Nurse Practitioner | 1150 N 35th Avenue, Suite 100, Hollywood, FL 33021 | 2016-10-20 |
| 1639629694 | Jada Santos | Psychologist | 1150 N 35th Avenue, Ste 590, Hollywood, FL 33021 | 2016-10-13 |
| 1396292702 | Krystina Serpa | Registered Nurse | 1150 N 35th Avenue, Ste 660, Hollywood, FL 33021 | 2016-09-01 |
| 1578924163 | Miriam Yonina Ross | Nurse Practitioner | 1150 N 35th Avenue, Suite 590, Hollywood, FL 33021 | 2016-03-10 |
| 1225420441 | Shari Selesky | Physician Assistant | 1150 N 35th Avenue, Ste 600, Hollywood, FL 33021 | 2015-02-25 |
| 1013308741 | Austin Horner | Physician Assistant | 1150 N 35th Avenue, Ste 600, Hollywood, FL 33021 | 2015-02-17 |
| 1043635899 | Riya Jacob | Nurse Practitioner | 1150 N 35th Avenue, Suite 605, Hollywood, FL 33021 | 2014-03-03 |
| 1831418458 | Armaal Rashard Hunter | Physician Assistant | 1150 N 35th Avenue, Suite 440, Hollywood, FL 33021-5430 | 2010-05-21 |
| 1982841599 | Justin Michael Bartl | Physician Assistant | 1150 N 35th Avenue, Ste 600, Hollywood, FL 33021 | 2009-01-20 |
| 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 | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376742114 | Stuart Paul Farber | Surgery | 3990 Sheridan St Ste 210, Hollywood, FL 33021-3656 | 2007-07-12 |
| 1629024377 | Susan B Fox | Surgery | 2699 Stirling Road, Suite 301/302a, Hollywood, FL 33312 | 2006-05-25 |
| 1033194535 | Jeffrey Alan Hertz | Surgery | 1150 N 35th Ave Ste 460, Hollywood, FL 33021 | 2005-12-07 |
| 1790229912 | Sholomo J Lanes Md Pa | Surgery | 3850 Hollywood Blvd, Suite 201, Hollywood, FL 33021-6748 | 2016-12-07 |
| 1215165121 | South Broward Vascular Associates LLC | Surgery | 3850 Hollywood Blvd, 302, Hollywood, FL 33021-6748 | 2009-06-30 |
| 1639145774 | Arthur E Palamara | Surgery | 1150 N 35th Ave Ste 460, Hollywood, FL 33021 | 2006-02-28 |
| 1871565010 | Sean O'donnell | Surgery | 1150 N 35th Ave Ste 460, Hollywood, FL 33021 | 2006-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104394857 | George Scott Hall Sr. | Surgery | 9 Marsh Creek Rd, Fernandina Beach, FL 32034-6413 | 2018-11-09 |
| 1316413115 | Fox Vascular Experts, LLC | Surgery | 2699 Stirling Rd Ste A301302, Fort Lauderdale, FL 33312-6517 | 2018-10-18 |
| 1114417508 | Vascular Center of Naples Inc. | Surgery | 5490 Bryson Dr Ste 201, Naples, FL 34109 | 2018-05-11 |
| 1598267593 | Joseph D Stillword, Md | Surgery | 800 Zeagler Dr Ste 320, Palatka, FL 32177-3827 | 2018-03-06 |
| 1386157006 | Beatriz Lam | Surgery | 2001 West 68 St, Cvicu, Hialeah, FL 33016 | 2017-11-16 |
| 1811421092 | Sunrise Vascular Center | Surgery | 8555 Nw 165th Ter, Miami Lakes, FL 33016-6138 | 2017-04-14 |
| 1962891838 | Global Trauma Systems, Inc | Surgery | 126 Se Mira Lavella, Port Saint Lucie, FL 34984-6615 | 2015-01-15 |
| 1184013450 | Vas-q-lar, Inc | Surgery | 6187 Nw 167th St, Suite H13, Hialeah, FL 33015-4340 | 2015-01-09 |
| 1396147138 | Usa Vein Clinics of Miami, LLC | Surgery | 1711 E Hallandale Beach Blvd Ste B, Hallandale Beach, FL 33009-4621 | 2014-09-24 |
| 1114336021 | Florida Vein Center, Inc | Surgery | 6050 53rd Ave E Unit A, Bradenton, FL 34203-9700 | 2014-08-05 |
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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.