| Memorial Division Of Infectious Disease | |
|
5647 Hollywood Blvd Hollywood FL 33021 | |
| (954) 276-1616 | |
| (954) 985-6186 |
| Full Name | Memorial Division Of Infectious Disease |
|---|---|
| Speciality | Internal Medicine |
| Location | 5647 Hollywood Blvd, Hollywood, Florida |
| Authorized Official Name and Position | Esther Surujon (CFO MPG, MPC & UCC) |
| Authorized Official Contact | 9542656677 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Division Of Infectious Disease 2900 Corporate Way Door D Miramar FL 33025-3925 Ph: (954) 276-5685 | Memorial Division Of Infectious Disease 5647 Hollywood Blvd Hollywood FL 33021 Ph: (954) 276-1616 |
| NPI Number | 1356712277 |
|---|---|
| Provider Enumeration Date | 10/19/2015 |
| Last Update Date | 10/17/2023 |
| Medicare PECOS PAC ID | 8123927373 |
|---|---|
| Medicare Enrollment ID | O20151228001564 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356712277 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Paula A Eckardt |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1720093552 PECOS PAC ID: 8527005636 Enrollment ID: I20050411000786 |
| Provider Name | Kenneth Poon |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1215182720 PECOS PAC ID: 9032391636 Enrollment ID: I20110302000992 |
| Provider Name | Paula Gyorok-love |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932119682 PECOS PAC ID: 5597921197 Enrollment ID: I20120726000252 |
| Provider Name | Heysu Rubio-gomez |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1780904581 PECOS PAC ID: 2264732379 Enrollment ID: I20151121000103 |
| Provider Name | Tara E Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659712834 PECOS PAC ID: 5395979397 Enrollment ID: I20170213002298 |
| Provider Name | Nathaniel C Duke |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1538375456 PECOS PAC ID: 4284913021 Enrollment ID: I20170520000176 |
| Provider Name | Brianna Kinney |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1396237749 PECOS PAC ID: 2365786217 Enrollment ID: I20181203003241 |
| Provider Name | Sheril Mary John |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194288035 PECOS PAC ID: 4082944814 Enrollment ID: I20190923000080 |
| Provider Name | Romina Bromberg |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1326433699 PECOS PAC ID: 9234488578 Enrollment ID: I20200902000938 |
| Provider Name | Edison J Cano Cevallos |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1982080339 PECOS PAC ID: 9032465976 Enrollment ID: I20210809002762 |
| Provider Name | Camille M Lusterio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700337904 PECOS PAC ID: 5799177416 Enrollment ID: I20220110000390 |
| Provider Name | Laureen A Biczak |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1073579074 PECOS PAC ID: 8729021068 Enrollment ID: I20220121001969 |
| Provider Name | Claudia P De La Matta Rodriguez |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1710409255 PECOS PAC ID: 6709269517 Enrollment ID: I20220811001292 |
| Provider Name | Garrett J Van Ostran |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1144746934 PECOS PAC ID: 2567847726 Enrollment ID: I20220923002383 |
| Provider Name | Dante P Melendez-lecca |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1396907499 PECOS PAC ID: 9335317767 Enrollment ID: I20231220000213 |
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