South Broward Hospital District
Family Medicine in Miramar, FL. Organization (NPI-2).
NPI number1194499863
StatusActive
Last updated in NPPESAug 5, 2021
Details
- NPI
- 1194499863
- Entity type
- Organization (NPI-2)
- Legal business name
- South Broward Hospital District
- Organization subpart
- Yes
- Enumeration date
- Aug 5, 2021
- Certification date
- Aug 5, 2021
- Last updated
- Aug 5, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- Memorial Primary Care Miramar Mob (Doing Business As)
Practice location
1951 Sw 172nd Ave Ste 210Miramar, FL 33029-5613
Phone 954-265-2789
Mailing address
2900 Corporate WayDoor D
Miramar, FL 33025-3925
Phone 954-276-5685 · Fax 954-985-7074
Authorized official
Esther Surujon
Cfo Mpg, Mpc And Ucc
9542656677
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