Provider Demographics
NPI:1407302045
Name:BROWARD HEALTH
Entity Type:Organization
Organization Name:BROWARD HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATHLETIC TRAINER
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:JEFFERSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:954-632-9809
Mailing Address - Street 1:2720 SOUTH OAKLAND FOREST DRIVE
Mailing Address - Street 2:APT.907
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309
Mailing Address - Country:US
Mailing Address - Phone:954-632-9809
Mailing Address - Fax:
Practice Address - Street 1:1800 SW 5TH PLACE
Practice Address - Street 2:
Practice Address - City:FT. LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309
Practice Address - Country:US
Practice Address - Phone:754-323-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 638273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit