Organization
SOUTH BROWARD HOSPITAL DISTRICT
Active
Organization
SOUTH BROWARD HOSPITAL DISTRICT
Active
Other names
Memorial Regional Hospital Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
IRFAN MIRZA (INTERIM CHIEF FINANCIAL OFFICER)
(954) 265-5636
Entity
Organization
Contact information
Practice address
4105 PEMBROKE RD, HOLLYWOOD, FL 33021-8103
(954) 265-8486
(954) 985-4899
Mailing address
4105 PEMBROKE RD, HOLLYWOOD, FL 33021-8103
(954) 265-8486
(954) 985-4899
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH22122
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004667700
—
FL
01
—
2007094
PK
—
Enumeration date
08/31/2006
Last updated
12/23/2025
Update your record
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