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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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