Basic Information
| Provider Information | |||||||||
| NPI: | 1265803480 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BROWARD HEALTH MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1346 SW 3RD CT | ||||||||
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| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333127591 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3053386233 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1600 S ANDREWS AVE | ||||||||
| Address2: | |||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333162510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547607171 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2015 | ||||||||
| LastUpdateDate: | 10/14/2015 | ||||||||
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| AuthorizedOfficialLastName: | RIVERA | ||||||||
| AuthorizedOfficialFirstName: | NINA | ||||||||
| AuthorizedOfficialMiddleName: | THAKKAR | ||||||||
| AuthorizedOfficialTitleorPosition: | CARDIOLOGY FELLOW | ||||||||
| AuthorizedOfficialTelephone: | 3053386233 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DO PHD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | OS13408 | FL | Y | Hospitals | General Acute Care Hospital |
No ID Information.