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
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