SOUTH BROWARD HOSPITAL DISTRICT (NPI# 1790076115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790076115 |
| Entity Type | Organization |
| Organization Name | SOUTH BROWARD HOSPITAL DISTRICT |
| Other Organization Name | MEMORIAL DIVISION OF PEDIATRIC IMMUNOLOGY, ALLERGY AND RHEUMATOLOGY |
| Practice Address |
1131 N 35th Ave Ste 220 Hollywood FL 33021-5403 |
| Mailing Address |
2900 Corporate Way Door D Miramar FL 33025-3925 |
| Practice Telephone | 9542653030 |
| Practice Fax Number | 9542653065 |
| Mailing Telephone | 9542765685 |
| Mailing Fax Number | 9549857074 |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2020-07-15 |
| 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 | 2080P0201X |
Pediatrics Specialization: Pediatric Allergy/Immunology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 009173529 | 05 | |
| FL | 009173570 | 05 | |
| FL | 038184537 | 05 | |
| FL | 009173526 | 05 |
| Other Name | Type Code |
|---|---|
| Memorial Division of Pediatric Immunology and Allergy | Doing Business As Name - Organization |
| Memorial Division of Pediatric Immunology, Allergy and Rheumatology | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1865 N Corporate Lakes Blvd Ste 1, Weston, FL 333263273 | 9542653030 | 9548936301 |
| 1951 Sw 172nd Ave Ste 204, Miramar, FL 330295613 | 9542653030 | 9548936301 |
| 20801 Biscayne Blvd Ste 201, Aventura, FL 331801422 | 9542653030 | 9542653065 |
| 20803 Biscayne Blvd Ste 204, Aventura, FL 331801429 | 9542653030 | 9542653065 |
| 3377 S State Rd 7, Suite 100, Wellington, FL 334498082 | 5613417000 | 5617847098 |
| 900 Glades Rd Ste 501, Boca Raton, FL 334316421 | 9542653030 | 9542653065 |
| 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 |
| 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 |
1131 N 35TH AVE STE 220 |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021-5403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063770865 | Nicole Christine Akar-ghibril | Pediatrics | 1131 N 35th Ave Ste 220, Hollywood, FL 33021-5403 | 2012-04-30 |
| 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 | 2080P0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Allergy/Immunology |
| A pediatrician who specializes in the diagnosis and treatment of allergies, allergic reactions, and immunologic diseases in children. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: title modified, definition added, source added] Additional Resources: A Certification of Special Qualifications (CSQ) is issued by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053322586 | Hary T. Katz | Pediatrics | 4123 University Blvd. S., Suite B, Jacksonville, FL 32216 | 2006-08-10 |
| 1427609080 | University of Miami | Pediatrics | 1580 Nw 10th Ave Fl 1, Miami, FL 33136-1013 | 2019-09-25 |
| 1598185480 | Camile Ortega | Pediatrics | 16371 Nw 67th Ave, Miami Lakes, FL 33014-6044 | 2014-04-18 |
| 1548607757 | David Squier Lindsay II | Pediatrics | 12901 Bruce B Downs Blvd, #3130, Tampa, FL 33612-4742 | 2013-05-29 |
| 1225393556 | Grace Toledo Padron | Pediatrics | 1580 Nw 10th Ave, Miami, FL 33136-1013 | 2012-07-12 |
| 1598058166 | Shajitha Melethil | Pediatrics | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2011-05-16 |
| 1538303631 | Amy Sarah Feldman | Pediatrics | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2009-04-21 |
| 1134394596 | Sthorn Thatayatikom | Pediatrics | 1600 Sw Archer Rd, Box 100371, Gainesville, FL 32610-0296 | 2008-04-28 |
| 1437349339 | American Medicine, Inc. | Pediatrics | 817 S University Dr, Suite 106, Plantation, FL 33324-3309 | 2007-07-26 |
| 1225117138 | Ilene Joy Goldstein | Pediatrics | 10301 Hagen Ranch Rd Ste 760, Boynton Beach, FL 33437-3777 | 2006-11-02 |
| 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.