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BRANDON PSYCHIATRIC GROUP LLC NPI 1952710147


NPI Information

NPI: 1952710147
Provider Name: BRANDON PSYCHIATRIC GROUP LLC
Classification: Psychiatry & Neurology - 2084B0040X
Entity Type: Organization

Specialization: Behavioral Neurology & Neuropsychiatry

Address:
106 W WINDHORST RD
BRANDON, FL
ZIP 33510
Phone: (678) 923-6025
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BRANDON PSYCHIATRIC GROUP LLC is a behavioral neurology and neuropsychiatry psychiatry neurology in Brandon, FL. The provider is behavioral Neurology & Neuropsychiatry is a medical subspecialty involving the diagnosis and treatment of neurologically based behavioral issues. BRANDON PSYCHIATRIC GROUP LLC NPI is 1952710147. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

106 W WINDHORST RD
BRANDON, FL
ZIP 33510-455
Phone: (678) 923-6025

The provider's authorized official is Hany Botros Mikhail .
The authorized official title is President and has the following contact phone number (678) 923-6025.

The enumeration date for this NPI number is 8/13/2014 and was last updated on 2/6/2019.


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
12084B0040XPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry95351FLORIDAYes

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
1275940302MEDICAIDFLORIDA

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: 11/14/2023

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