Organization · Type 2 NPI

South Broward Hospital District

Pediatric Adolescent Medicine Physician · Hollywood, FL

NPI number 1407208952 Active

Practice location

1150 N 35th Ave Ste 560
Hollywood, FL 33021

Call (954) 265-1460 Map

Fax (954) 265-1375

Mailing address

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

Other practice locations

1971 SW 172nd Ave Ste 2500, Miramar, FL 33029-5621 · (954) 265-1460

Specialties and licenses

Taxonomy	Code	License
Pediatric Adolescent Medicine Physician Primary	2080A0000X	None listed

Pediatric Adolescent Medicine Physician: A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

4 other providers at this address

NPI record

NPI: 1407208952
Entity type: Organization (Type 2)
Issued: Jul 8, 2016
Last updated: May 13, 2025
Status: Active
Subpart: Yes of South Broward Hospital District

Other names

<unavail>
Memorial Division of Adolescent Medicine · doing business as

Authorized official

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

Verify this record

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.

Is this your record? How to update it.

About NPI 1407208952

South Broward Hospital District's National Provider Identifier is 1407208952, issued on Jul 8, 2016. The primary taxonomy on file is Pediatric Adolescent Medicine Physician (2080A0000X), and the practice location is in Hollywood, FL. The record was last updated on May 13, 2025.