Provider Demographics
NPI:1518129212
Name:BROWARD COMMUNITY AND FAMILY HEALTH CENTERS INC
Entity Type:Organization
Organization Name:BROWARD COMMUNITY AND FAMILY HEALTH CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROSALYN
Authorized Official - Middle Name:R
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-967-0028
Mailing Address - Street 1:5010 HOLLYWOOD BLVD
Mailing Address - Street 2:100B
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6557
Mailing Address - Country:US
Mailing Address - Phone:954-967-0028
Mailing Address - Fax:954-971-9503
Practice Address - Street 1:168 N POWERLINE RD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-5713
Practice Address - Country:US
Practice Address - Phone:954-970-8805
Practice Address - Fax:954-582-0556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL680027102Medicaid
FL680027103Medicaid
FL101931Medicare Oscar/Certification
FLK1082Medicare PIN