Provider Demographics
NPI:1376627778
Name:DOH BROWARD COUNTY PUBLIC HEALTH UNIT
Entity type:Organization
Organization Name:DOH BROWARD COUNTY PUBLIC HEALTH UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-467-4811
Mailing Address - Street 1:333 SW 28TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33315-2637
Mailing Address - Country:US
Mailing Address - Phone:954-467-4877
Mailing Address - Fax:954-467-4878
Practice Address - Street 1:333 SW 28TH ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33315-2637
Practice Address - Country:US
Practice Address - Phone:954-467-4877
Practice Address - Fax:954-467-4878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH6758261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local