Organization · Type 2 NPI

South Broward Hospital District

Child & Adolescent Psychiatry Physician · Hollywood, FL

NPI number 1336504075 Active

Practice location

3440 Hollywood Blvd Ste 360
Hollywood, FL 33021-6934

Call (954) 276-9200 Map

Fax (954) 275-0733

Mailing address

2900 Corporate Way, Mpg Door D
Miramar, FL 33025-3925

Other practice locations

5458 Town Center Rd Ste 102, Boca Raton, FL 33486-1026 · (954) 276-9200

Specialties and licenses

Taxonomy	Code	License
Child & Adolescent Psychiatry Physician Primary	2084P0804X	None listed

Child & Adolescent Psychiatry Physician: Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

5 other providers at this address

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NPI record

NPI: 1336504075
Entity type: Organization (Type 2)
Issued: Dec 23, 2015
Last updated: Jul 14, 2025
Status: Active
Subpart: Yes of South Broward Hospital District

Other names

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Memorial Division of Child/adolescent Psychiatry · doing business as
Memorial Division of Child/adolescent Psychiatry · doing business as

Authorized official

Esther Surujon
CFO Mpg, MPC and Ucc
(954) 265-6677

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1336504075

South Broward Hospital District's National Provider Identifier is 1336504075, issued on Dec 23, 2015. The primary taxonomy on file is Child & Adolescent Psychiatry Physician (2084P0804X), and the practice location is in Hollywood, FL. The record was last updated on Jul 14, 2025.