Organization
BROWARD OUTPATIENT MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACEY B CASTROVINCI R.N. (DIRECTOR OF OPERATIONS)
(954) 941-2969
Entity
Organization
Contact information
Practice address
150 S ANDREWS AVE, SUITE 201, POMPANO BEACH, FL 33069-3298
(954) 941-2969
(954) 960-6858
Mailing address
150 S ANDREWS AVE, SUITE 201, POMPANO BEACH, FL 33069-3298
(954) 941-2969
(954) 960-6858
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130076931
OCCUPATIONAL LICENSE
FL
Enumeration date
03/27/2013
Last updated
06/13/2016
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