| Broward Institute Of Neuro Science L L C | |
|
7501 Wiles Rd Ste 105 Coral Springs FL 33067-2063 | |
| (954) 341-1022 | |
| (954) 341-1082 |
| Full Name | Broward Institute Of Neuro Science L L C |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7501 Wiles Rd Ste 105, Coral Springs, Florida |
| Authorized Official Name and Position | Ricardo K Espaillat (CLINICAL DIRECTOR/CHAIRMAN) |
| Authorized Official Contact | 9543411022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Broward Institute Of Neuro Science L L C 7501 Wiles Rd Ste 105 Coral Springs FL 33067-2063 Ph: (954) 341-1022 | Broward Institute Of Neuro Science L L C 7501 Wiles Rd Ste 105 Coral Springs FL 33067-2063 Ph: (954) 341-1022 |
| NPI Number | 1245429463 |
|---|---|
| Provider Enumeration Date | 10/24/2007 |
| Last Update Date | 11/05/2021 |
| Certification Date | 11/05/2021 |
| Medicare PECOS PAC ID | 0547348997 |
|---|---|
| Medicare Enrollment ID | O20080424000724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245429463 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | BE8849854 (Florida) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Ricardo Espaillat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700838372 PECOS PAC ID: 7012974728 Enrollment ID: I20041214001062 |
| Provider Name | Yanisleidy Estevez Monteagudo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386001394 PECOS PAC ID: 3577909357 Enrollment ID: I20240314004186 |
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