Organization · Type 2 NPI

South Broward Hospital District

Pediatric Allergy/Immunology Physician · Hollywood, FL

NPI number 1790076115 Active

Practice location

1131 N 35th Ave Ste 220
Hollywood, FL 33021-5403

Call (954) 265-3030 Map

Fax (954) 265-3065

Mailing address

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

Other practice locations

3377 S State Rd 7, Suite 100, Wellington, FL 33449-8082 · (561) 341-7000
1951 SW 172nd Ave Ste 415, Miramar, FL 33029-5614 · (954) 265-3030
601 N Flamingo Rd Ste 403, Pembroke Pines, FL 33028-1011 · (954) 265-3030
1150 N 35th Ave Ste 490, Hollywood, FL 33021-5423 · (954) 265-3437
900 Glades Rd Ste 501, Boca Raton, FL 33431-6421 · (954) 265-3030

Specialties and licenses

Taxonomy	Code	License
Pediatric Allergy/Immunology Physician Primary	2080P0201X	None listed

Pediatric Allergy/Immunology Physician: A pediatrician who specializes in the diagnosis and treatment of allergies, allergic reactions, and immunologic diseases in children.

6 other providers at this address

NPI record

NPI: 1790076115
Entity type: Organization (Type 2)
Issued: Apr 20, 2011
Last updated: Jan 6, 2026
Status: Active
Subpart: Yes of South Broward Hospital District

Other names

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Memorial Division of Immunology, Allergy and Pediatric Rheumatology · doing business as

Authorized official

Esther Surujon
CFO Mpg, MPC & 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 1790076115

South Broward Hospital District's National Provider Identifier is 1790076115, issued on Apr 20, 2011. The primary taxonomy on file is Pediatric Allergy/Immunology Physician (2080P0201X), and the practice location is in Hollywood, FL. The record was last updated on Jan 6, 2026.