Organization
HOLLYWOOD PAVILION LLC
Active
Organization
HOLLYWOOD PAVILION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN KALLEN-ZURY (CEO)
(954) 962-1355
Entity
Organization
Contact information
Practice address
1201 N 37TH AVE, HOLLYWOOD, FL 33021-5414
(954) 962-1355
(954) 981-5520
Mailing address
1201 N 37TH AVE, HOLLYWOOD, FL 33021-5414
(954) 962-1355
(954) 981-5520
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
4361
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E80
BLUE CROSS PROVIDER NUMBE
FL
Enumeration date
01/13/2006
Last updated
08/22/2020
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