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NICOLE KALLSTROM
NPI 1477079168
Pediatrics - Pediatric Critical Care Medicine in Hollywood, FL

Active since August 15, 2017
3501 JOHNSON ST, HOLLYWOOD, FL 33021(954) 265-5970 Get Directions Write a Review

NPPES record last updated: March 23, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Mar 23, 2021, Aug 15, 2017 (2 updates tracked since 2017).

About Nicole Kallstrom NPPES

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

NICOLE KALLSTROM (NPI 1477079168) is an individual pediatric critical care medicine provider in Hollywood, Florida, licensed in Florida (ARNP934484) and active in the NPI registry since August 2017.

NPPES Registry Identity

NPI1477079168
Entity TypeIndividualFemale
Primary Taxonomy2080P0203X
Provider Legal NameNICOLE KALLSTROM
Location Address3501 JOHNSON STHollywood, FL 33021-5421
Mailing Address1117 E Hallandale Beach BlvdHallandale Beach, FL 33009-4488
Phone(954) 265-5970
Sole ProprietorNo
Enumeration DateAugust 15, 2017
Last NPPES UpdateMarch 23, 20212 updates tracked since enumeration
NPPES CertifiedMarch 23, 2021
✔ NPI 1477079168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0203X
License✔ Licensed in FL · ARNP934484
Definition
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License ARNP934484 (FL)
3501 JOHNSON ST, Hollywood, FL 33021
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Other Providers at the Same Location NPPES 20

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

DR. LESTER GOLDBERG M.D.
Radiology (Diagnostic Radiology)
3501 JOHNSON ST
HOLLYWOOD, FL 33021
Broward County (954) 987-2000
DR. TIMOTHY M. BURKE D.O.
Emergency Medicine
3501 JOHNSON ST
HOLLYWOOD, FL 33021
Broward County (954) 987-2000
DR. MOHAMMAD ALI ANSARI LARI M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
3501 JOHNSON ST
HOLLYWOOD, FL 33021
Broward County (954) 985-5921
DR. STANLEY JARED CHANG M.D.
Radiology (Diagnostic Radiology)
3501 JOHNSON ST
HOLLYWOOD, FL 33021
Broward County (954) 437-4800
SAMANTHA THEMAS
Pharmacist
3501 JOHNSON ST
HOLLYWOOD, FL 33021
Broward County (954) 265-5900
DR. CHANCE MILAN YURCO PHARMD, RPH
Pharmacist
3501 JOHNSON ST
HOLLYWOOD, FL 33021
Broward County (954) 987-2000
MR. GREGORY GRAVES JR. CAA
Anesthesiologist Assistant
3501 JOHNSON ST
HOLLYWOOD, FL 33021
Broward County (954) 939-5000
DR. SHERRY LOU WOODHOUSE M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
3501 JOHNSON ST
HOLLYWOOD, FL 33021
Broward County (954) 985-5921

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 Nicole Kallstrom's NPI number?

The NPI number for Nicole Kallstrom is 1477079168. It was assigned to this individual provider in the NPPES registry on August 15, 2017.

Where is Nicole Kallstrom located?

Nicole Kallstrom practices at 3501 Johnson St, Hollywood, FL 33021. The listed phone number is (954) 265-5970.

What is Nicole Kallstrom's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

When was this NPI record last updated?

The NPPES record for Nicole Kallstrom was last updated on March 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.