| Child Neurology Llc | |
|
4440 Sheridan Street Hollywood FL 33021 | |
| (954) 961-2423 | |
| (954) 961-4860 |
| Full Name | Child Neurology Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology |
| Location | 4440 Sheridan Street, Hollywood, Florida |
| Authorized Official Name and Position | Tatyana Dubrovsky (MANAGER OF THE CHILD NEUROLOGY LLC) |
| Authorized Official Contact | 9549612423 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Child Neurology Llc 4440 Sheridan Street Hollywood FL 33021 Ph: (954) 961-2423 | Child Neurology Llc 4440 Sheridan Street Hollywood FL 33021 Ph: (954) 961-2423 |
| NPI Number | 1710924956 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 05/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710924956 | NPI | - | NPPES |
| 77841 | Other | FL | BLUE CROSS BLUE SHIELD |
| 276469500 | Other | FL | PEDIATRIC ASSOCIATES PSN |
| 276469500 | Other | FL | FL NETPASS |
| 276469500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | ME70907 (Florida) | Primary |
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