Organization
SOUTH BROWARD HOSPITAL DISTRICT
Active
Other names
Memorial Regional Outpatient Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
IRFAN MIRZA (INTERIM CHIEF FINANCIAL OFFICER)
(954) 265-5696
Entity
Organization
Contact information
Practice address
1150 N 35TH AVE, SUITE 105, HOLLYWOOD, FL 33021
(954) 265-1299
(954) 276-0292
Mailing address
1150 N 35TH AVE, SUITE 105, HOLLYWOOD, FL 33021
(954) 265-1299
(954) 276-0292
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH8171
FL
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0046674-00
—
FL
05
—
0046674-01
—
FL
01
—
2010548
PK
—
Enumeration date
02/08/2007
Last updated
12/23/2025
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