South Broward Hospital District
NPI 1063013787 · Pediatrics Physician · Hollywood, FL
Enrolled with Medicare as Part B Supplier - Hospital Department(s) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1063013787
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- South Broward Hospital District
- Organization subpart
- Yes
- Authorized official
- Esther Surujon, Chief Financial Officer Mpg and Mpc(954) 265-6677
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Memorial Division of Pediatric Complex Care
- Doing business as
- Memorial Division of Pediatric Complex Care
Additional practice locations (1)
- 1971 Sw 172nd Ave Ste 2500Miramar, FL 33029-5621Phone: (954) 265-4494Fax: (954) 276-0702
Registry dates
- Enumerated
- 2020-11-09
- Last updated
- 2025-10-03
- Certified
- 2025-10-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.