Provider Demographics
NPI:1255357703
Name:BROWARD NURSING & REHABILITATION CENTER,LLC
Entity type:Organization
Organization Name:BROWARD NURSING & REHABILITATION CENTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HYMANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-524-5587
Mailing Address - Street 1:1330 S ANDREWS AVE
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1838
Mailing Address - Country:US
Mailing Address - Phone:954-524-5587
Mailing Address - Fax:954-463-4428
Practice Address - Street 1:1330 S ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1838
Practice Address - Country:US
Practice Address - Phone:954-524-5587
Practice Address - Fax:954-463-4428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF10670962314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0226335-00Medicaid
FL105083Medicare Oscar/Certification