| Memorial Division Of Neurology | |
|
1150 N 35th Ave Ste 590 Hollywood FL 33021-5468 | |
| (954) 265-9500 | |
| (954) 265-1431 |
| Full Name | Memorial Division Of Neurology |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1150 N 35th Ave Ste 590, Hollywood, Florida |
| Authorized Official Name and Position | Esther Surujon (CFO MPG, MPC & UCC) |
| Authorized Official Contact | 9542656677 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Division Of Neurology 2900 Corporate Way Mpg Door D Miramar FL 33025-3925 Ph: (954) 276-5685 | Memorial Division Of Neurology 1150 N 35th Ave Ste 590 Hollywood FL 33021-5468 Ph: (954) 265-9500 |
| NPI Number | 1700216496 |
|---|---|
| Provider Enumeration Date | 11/18/2013 |
| Last Update Date | 03/29/2024 |
| Certification Date | 03/29/2024 |
| Medicare PECOS PAC ID | 8123927373 |
|---|---|
| Medicare Enrollment ID | O20140321000652 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700216496 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Sean Shea |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760489397 PECOS PAC ID: 6305833054 Enrollment ID: I20100303000536 |
| Provider Name | George C Diaz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083611677 PECOS PAC ID: 1456496348 Enrollment ID: I20100303000782 |
| Provider Name | Paul L Ginsberg |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043261068 PECOS PAC ID: 4981734506 Enrollment ID: I20100608000917 |
| Provider Name | Jonathan S Cross |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336146927 PECOS PAC ID: 0749325637 Enrollment ID: I20100809001104 |
| Provider Name | Seth Craig Tarras |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932140902 PECOS PAC ID: 1052581295 Enrollment ID: I20110826000487 |
| Provider Name | Tatyana Dubrovsky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912116450 PECOS PAC ID: 9234301847 Enrollment ID: I20111004000165 |
| Provider Name | Sean T Kenniff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720308034 PECOS PAC ID: 7315185360 Enrollment ID: I20130603000314 |
| Provider Name | Mhd Tarek M Zakaria |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144422502 PECOS PAC ID: 3577622141 Enrollment ID: I20140312001110 |
| Provider Name | Joshuae German Gallardo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689985962 PECOS PAC ID: 7012134851 Enrollment ID: I20140819000324 |
| Provider Name | Madiley Broz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790174563 PECOS PAC ID: 4284952029 Enrollment ID: I20150416002237 |
| Provider Name | Maike T Blaya |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750583126 PECOS PAC ID: 3577601574 Enrollment ID: I20150721003112 |
| Provider Name | Adnan M Subei |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962722876 PECOS PAC ID: 6103046461 Enrollment ID: I20150826002592 |
| Provider Name | Catherine Deutsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104235340 PECOS PAC ID: 4587971288 Enrollment ID: I20150914000197 |
| Provider Name | Susanne Gonzalez Gallardo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609192814 PECOS PAC ID: 5890004113 Enrollment ID: I20151027001198 |
| Provider Name | Jada Caridad Santos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639629694 PECOS PAC ID: 7214217462 Enrollment ID: I20161206001518 |
| Provider Name | Zulema Arbide |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154584167 PECOS PAC ID: 3577831593 Enrollment ID: I20170616000010 |
| Provider Name | Anita Evelyn Arias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861942443 PECOS PAC ID: 1153690128 Enrollment ID: I20170706002504 |
| Provider Name | Miriam Y Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578924163 PECOS PAC ID: 6507122421 Enrollment ID: I20171109001565 |
| Provider Name | Fiorella Jahaira Saka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003326281 PECOS PAC ID: 0749549319 Enrollment ID: I20180108000599 |
| Provider Name | Bandi Lea Tawny Davini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033622527 PECOS PAC ID: 1759642564 Enrollment ID: I20180219000647 |
| Provider Name | Mohammed Qureshi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174934434 PECOS PAC ID: 9931328085 Enrollment ID: I20190205003530 |
| Provider Name | Buse Sengul |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538575824 PECOS PAC ID: 9739425117 Enrollment ID: I20190809000780 |
| Provider Name | Kimberly N Lakey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124669635 PECOS PAC ID: 2769815000 Enrollment ID: I20191127001471 |
| Provider Name | Brandi Baker |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003298852 PECOS PAC ID: 2860706777 Enrollment ID: I20200729000732 |
| Provider Name | Donald C Barr |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215348313 PECOS PAC ID: 6800175332 Enrollment ID: I20200821001583 |
| Provider Name | Fawad Yousuf |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851822670 PECOS PAC ID: 4486054418 Enrollment ID: I20210614001892 |
| Provider Name | Noureldin Mohamed Abdelhamid |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811275076 PECOS PAC ID: 1254651912 Enrollment ID: I20210804000117 |
| Provider Name | Jacqueline D Tippett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194344820 PECOS PAC ID: 4284030792 Enrollment ID: I20210909000412 |
| Provider Name | Karim Salame |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215190681 PECOS PAC ID: 2062633068 Enrollment ID: I20210916000254 |
| Provider Name | Dailis E Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720740053 PECOS PAC ID: 4587048624 Enrollment ID: I20220908002341 |
| Provider Name | Christopher Arocha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386342988 PECOS PAC ID: 1456719723 Enrollment ID: I20230618000074 |
| Provider Name | Ana Isabel Coronado |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962924563 PECOS PAC ID: 7113255944 Enrollment ID: I20230620000742 |
| Provider Name | Brigitte E Farnsworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992478200 PECOS PAC ID: 3779937339 Enrollment ID: I20230929003517 |
| Provider Name | Mohamed Nasser |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699279638 PECOS PAC ID: 5092066233 Enrollment ID: I20231011003763 |
| Provider Name | Gaurav Kathuria |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346700739 PECOS PAC ID: 7517200025 Enrollment ID: I20231201002094 |
| Provider Name | Sadia Waheed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386104487 PECOS PAC ID: 0749516128 Enrollment ID: I20231204002138 |
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