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MEMORIAL DIVISION OF PEDIATRIC OTOLARYNGOLOGY NPI 1053657650


NPI Information

NPI: 1053657650
Provider Name: MEMORIAL DIVISION OF PEDIATRIC OTOLARYNGOLOGY
Classification: Physician Assistant - 363A00000X
Entity Type: Organization

CLIA Number: 10D1007909

Address:
1150 N 35TH AVE
SUITE 490
HOLLYWOOD, FL
ZIP 33021
Phone: (954) 265-1616
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MEMORIAL DIVISION OF PEDIATRIC OTOLARYNGOLOGY is a physician assistant in Hollywood, FL. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. MEMORIAL DIVISION OF PEDIATRIC OTOLARYNGOLOGY NPI is 1053657650. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1150 N 35TH AVE
SUITE 490
HOLLYWOOD, FL
ZIP 33021-424
Phone: (954) 265-1616
Fax: (954) 893-6325

The provider's authorized official is Samuel Ostrower .
The authorized official title is Otolaryngologist and has the following contact phone number (954) 265-1616.

The CLIA number assigned to this NPI record is 10D1007909 - other - cardiac & pulmonary rehab with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/31/2012 and was last updated on 12/31/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician AssistantPA9106938FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1PA9106938OTHERFLORIDAMEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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