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South Broward Hospital District

Physician Assistant, Surgical in Hollywood, FL. Organization (NPI-2).

NPI number1285641209
StatusActive
Last updated in NPPESFeb 16, 2017

Details

NPI
1285641209
Entity type
Organization (NPI-2)
Legal business name
South Broward Hospital District
Organization subpart
No
Enumeration date
Aug 2, 2006
Last updated
Feb 16, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363AS0400X Physician Assistant, Surgical––Yes

Other names

  • Memorial Division Of Professional Services (Doing Business As)

Practice location

3501 Johnson Street
Hollywood, FL 33021

Phone 954-987-2000 · Fax 954-985-5691

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925

Phone 954-276-5685 · Fax 954-985-7074

Authorized official

Mario Salceda-Cruz
Administrator
9542654684

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