South Broward Hospital District | |
1951 Sw 172nd Ave Ste 210 Miramar FL 33029-5613 | |
(954) 265-2789 | |
Not Available |
Full Name | South Broward Hospital District |
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Speciality | Family Medicine |
Location | 1951 Sw 172nd Ave Ste 210, Miramar, Florida |
Authorized Official Name and Position | Esther Surujon (CFO MPG, MPC AND UCC) |
Authorized Official Contact | 9542656677 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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South Broward Hospital District 2900 Corporate Way Door D Miramar FL 33025-3925 Ph: (954) 276-5685 | South Broward Hospital District 1951 Sw 172nd Ave Ste 210 Miramar FL 33029-5613 Ph: (954) 265-2789 |
NPI Number | 1194499863 |
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Provider Enumeration Date | 08/05/2021 |
Last Update Date | 08/05/2021 |
Medicare PECOS PAC ID | 8123927373 |
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Medicare Enrollment ID | O20211007000295 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194499863 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Perla Del Pino-white |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1245449487 PECOS PAC ID: 6507939402 Enrollment ID: I20090302000326 |
Provider Name | Carmen M Hurtado |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1710914106 PECOS PAC ID: 9931273596 Enrollment ID: I20141112000677 |
Provider Name | Shery Goril |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689038838 PECOS PAC ID: 0446597819 Enrollment ID: I20231031003399 |
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