Provider Demographics
NPI:1265541254
Name:HOSPITAL WITHOUT WALLS OF BROWARD, INC.
Entity type:Organization
Organization Name:HOSPITAL WITHOUT WALLS OF BROWARD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BAHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HABIB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-984-8485
Mailing Address - Street 1:2310 NW 3RD AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-4963
Mailing Address - Country:US
Mailing Address - Phone:954-984-8485
Mailing Address - Fax:954-984-0354
Practice Address - Street 1:2310 NW 3RD AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-4963
Practice Address - Country:US
Practice Address - Phone:954-984-8485
Practice Address - Fax:954-984-0354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10-8297Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER