Provider Demographics
NPI:1720703598
Name:NORTH BROWARD HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:NORTH BROWARD HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM CFO
Authorized Official - Prefix:
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-847-4117
Mailing Address - Street 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-473-7642
Mailing Address - Fax:
Practice Address - Street 1:1101 W BROWARD BLVD
Practice Address - Street 2:MOBILE HEALTH UNIT
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-8905
Practice Address - Country:US
Practice Address - Phone:954-527-6041
Practice Address - Fax:954-527-6052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty