Basic Information
| Provider Information | |||||||||
| NPI: | 1841414471 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NORTH BROWARD HOSPITAL DISTRICT | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | HOSPICE OF GOLD COAST | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2101 W COMMERCIAL BLVD | ||||||||
| Address2: | SUITE 4500 | ||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333093071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547852990 | ||||||||
| FaxNumber: | 9547885034 | ||||||||
| Practice Location | |||||||||
| Address1: | 2101 W COMMERCIAL BLVD | ||||||||
| Address2: | SUITE 4500 | ||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333093071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547852990 | ||||||||
| FaxNumber: | 9547885034 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | NAST | ||||||||
| AuthorizedOfficialFirstName: | FRANK | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 9543555064 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | 5017096 | FL | Y | Agencies | Hospice Care, Community Based |
No ID Information.