THE BRAIN SPA LLC NPI 1063907517

NPI Information

  • NPI: 1063907517
  • Provider Name: THE BRAIN SPA, LLC
  • Classification: Psychiatry & Neurology - 2084P0802X
  • Specialization: Addiction Psychiatry
  • Entity Type: Organization
  • CLIA Number: 10D2172726
  • Address: 210 JUPITER LAKES BLVD STE 3102
    JUPITER, FL
    ZIP 33458
  • Phone: (561) 406-6561

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NPI Details

THE BRAIN SPA, LLC is an addiction psychiatry psychiatry neurology in Jupiter, FL. The provider is addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders. THE BRAIN SPA, LLC NPI is 1063907517. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

210 JUPITER LAKES BLVD STE 3102
JUPITER, FL
ZIP 33458
Phone: (561) 406-6561
Fax: (561) 406-6629

The provider's authorized official is Edward Leonardo Barias .
The authorized official title is Medical Director/owner and has the following contact phone number (561) 406-6561.

The CLIA number assigned to this NPI record is 10D2172726 - other - substance abuse facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/27/2018 and was last updated on 8/30/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0802XPsychiatry & NeurologyAddiction PsychiatryME119718FLORIDAYes

What is NPI?

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This page was last updated on: 11/21/2025

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