Provider Demographics
NPI:1902040454
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:
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:954-272-0294
Practice Address - Street 1:5801 HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-5243
Practice Address - Country:US
Practice Address - Phone:954-966-3939
Practice Address - Fax:954-966-5959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
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
FL680027104Medicaid
FL680027105Medicaid
FL680027104Medicaid
FL101037Medicare Oscar/Certification