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MEMORIAL MEDICAL GROUP OF SOUTH FLORIDA, LLC
NPI 1336806801
Physician Assistant in Hollywood, FL

Active since November 19, 2021
4000 HOLLYWOOD BLVD STE 555S, HOLLYWOOD, FL 33021(754) 273-0885(833) 955-3596 Get Directions Write a Review

NPPES record last updated: November 19, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Memorial Medical Group Of South Florida, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEMORIAL MEDICAL GROUP OF SOUTH FLORIDA, LLC (NPI 1336806801), doing business as Memorial Mental Health Of South Florida, is a healthcare organization registered as a physician assistant in Hollywood, Florida and active in the NPI registry since November 2021. The organization lists Lisa B Marshall, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1336806801
Entity TypeOrganization
Primary Taxonomy363A00000X
Legal Business NameMEMORIAL MEDICAL GROUP OF SOUTH FLORIDA, LLC
Location Address4000 HOLLYWOOD BLVD STE 555SHollywood, FL 33021-6853
Mailing Address16000 Pines Boulevard, #822503Pembroke Pines, FL 33082-2503 · (754) 273-0885 · Fax (754) 240-7841
Phone(754) 273-0885
Fax(833) 955-3596
Organization SubpartNo
Authorized OfficialLisa B MarshallMedical Director · (754) 273-0885
Enumeration DateNovember 19, 2021
NPPES CertifiedAugust 6, 2020
✔ NPI 1336806801 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition

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.

4000 HOLLYWOOD BLVD STE 555S, Hollywood, FL 33021
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Other Names 1

Doing Business AsMemorial Mental Health Of South Florida

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELANIE GASILOVSKIY RBT
Behavior Technician
4000 HOLLYWOOD BLVD STE 555S
HOLLYWOOD, FL 33021
Broward County (954) 400-3251
JOHANA BASERIO
Behavior Technician
4000 HOLLYWOOD BLVD STE 555S
HOLLYWOOD, FL 33021
Broward County (954) 400-3251
CARING PROFESSIONAL HEALTHCARE, LLC
Registered Nurse (Administrator)
4000 HOLLYWOOD BLVD STE 555S
HOLLYWOOD, FL 33021
Broward County (954) 638-5363
ALYSSA KEATS RBT
Behavior Technician
4000 HOLLYWOOD BLVD STE 555S
HOLLYWOOD, FL 33021
Broward County (954) 400-3251
CRISTINA MARIE RODRIGUEZ RIVERA
Behavior Technician
4000 HOLLYWOOD BLVD STE 555S
HOLLYWOOD, FL 33021
Broward County (954) 400-3251
DAIMARA ALEMAN
Behavior Technician
4000 HOLLYWOOD BLVD STE 555S
HOLLYWOOD, FL 33021
Broward County (954) 400-3251
DERELL P THOMAS
Day Training, Developmentally Disabled Services
4000 HOLLYWOOD BLVD STE 555S
HOLLYWOOD, FL 33021
Broward County (954) 843-3502
PREFERRED CARE AT HOME OF SOUTH BROWARD
In Home Supportive Care
4000 HOLLYWOOD BLVD STE 555S
HOLLYWOOD, FL 33021
Broward County (954) 695-6601

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Memorial Medical Group Of South Florida, LLC's NPI number?

The NPI number for Memorial Medical Group Of South Florida, LLC is 1336806801. It was assigned to this organization in the NPPES registry on November 19, 2021. The provider is doing business as Memorial Mental Health Of South Florida.

Where is Memorial Medical Group Of South Florida, LLC located?

Memorial Medical Group Of South Florida, LLC is located at 4000 Hollywood Blvd Ste 555S, Hollywood, FL 33021. The listed phone number is (754) 273-0885.

What is Memorial Medical Group Of South Florida, LLC's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Memorial Medical Group Of South Florida, LLC was last updated on November 19, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.