Organization · Type 2 NPI

South Broward Hospital District

Psychiatry Physician · Hollywood, FL

NPI number 1417491127 Active

Practice location

3440 Hollywood Blvd Ste 360
Hollywood, FL 33021-6934

Call (954) 276-9240 Map

Fax (954) 276-0103

Mailing address

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

Specialties and licenses

Taxonomy	Code	License
Psychiatry Physician Primary	2084P0800X	None listed

Psychiatry Physician: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic la…

5 other providers at this address

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NPI record

NPI: 1417491127
Entity type: Organization (Type 2)
Issued: Dec 14, 2016
Last updated: Jun 21, 2023
Status: Active
Subpart: Yes of South Broward Hospital District

Other names

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Memorial Division of Psychiatry Services · doing business as

Authorized official

Esther Surujon
CFO MPG and MPC
(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 1417491127

South Broward Hospital District's National Provider Identifier is 1417491127, issued on Dec 14, 2016. The primary taxonomy on file is Psychiatry Physician (2084P0800X), and the practice location is in Hollywood, FL. The record was last updated on Jun 21, 2023.