Provider Demographics
NPI:1205890803
Name:BROWARD EAR NOSE THROAT & ALLERGY PA
Entity type:Organization
Organization Name:BROWARD EAR NOSE THROAT & ALLERGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIVATE PRACTITIONER IN GROUP PRACT
Authorized Official - Prefix:DR
Authorized Official - First Name:SABINE
Authorized Official - Middle Name:VERA
Authorized Official - Last Name:HESSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-583-7770
Mailing Address - Street 1:1317 SE 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316
Mailing Address - Country:US
Mailing Address - Phone:954-583-7770
Mailing Address - Fax:954-583-6226
Practice Address - Street 1:1317 SE 4TH AVE
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1913
Practice Address - Country:US
Practice Address - Phone:954-583-7770
Practice Address - Fax:954-583-6226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263117200Medicaid
FL263117200Medicaid