RADIUS TBI OF SOUTH FLORIDA NPI 1558886069

NPI Information

  • NPI: 1558886069
  • Provider Name: RADIUS TBI OF SOUTH FLORIDA
  • Classification: Psychiatry & Neurology - 2084P0301X
  • Specialization: Brain Injury Medicine
  • Entity Type: Organization
  • Doing Business As: RADIUS TBI
  • Address: 4330 W BROWARD BLVD STE G
    PLANTATION, FL
    ZIP 33317
  • Phone: (954) 598-0779

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NPI Details

RADIUS TBI OF SOUTH FLORIDA is a brain injury medicine psychiatry neurology in Plantation, FL. The provider is a Brain Injury Medicine physician specializes in disorders of brain function due to injury and disease. These disorders encompass a range of medical, physical, neurologic, cognitive, sensory, and behavioral disorders that result in psychosocial, educational, and vocational consequences. RADIUS TBI OF SOUTH FLORIDA NPI is 1558886069. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Radius Tbi.

The provider's business location address is:

4330 W BROWARD BLVD STE G
PLANTATION, FL
ZIP 33317-753
Phone: (954) 598-0779

The provider's authorized official is Brian Mevorah .
The authorized official title is Ceo and has the following contact phone number (954) 471-2133.

The enumeration date for this NPI number is 8/4/2017 and was last updated on 7/21/2022.

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
1103G00000XClinical NeuropsychologistNo
2103TB0200XPsychologistCognitive & BehavioralNo
3103TC1900XPsychologistCounselingNo
42084P0301XPsychiatry & NeurologyBrain Injury MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11346605011OTHERFLORIDANPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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