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RADIUS TBI OF SOUTH FLORIDA NPI 1558886069


NPI Information

NPI: 1558886069
Provider Name: RADIUS TBI OF SOUTH FLORIDA

Doing Business As: RADIUS TBI

Classification: Psychiatry & Neurology - 2084P0301X
Entity Type: Organization

Specialization: Brain Injury Medicine

Address:
4330 W BROWARD BLVD STE G
PLANTATION, FL
ZIP 33317
Phone: (954) 598-0779
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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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther 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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.