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 |
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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 |
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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 |
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Provider Enumeration Date | 11/18/2013 |
Last Update Date | 03/29/2024 |
Certification Date | 03/29/2024 |
Medicare PECOS PAC ID | 8123927373 |
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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 |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1760489397 PECOS PAC ID: 6305833054 Enrollment ID: I20100303000536 |
Provider Name | George C Diaz |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1083611677 PECOS PAC ID: 1456496348 Enrollment ID: I20100303000782 |
Provider Name | Paul L Ginsberg |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1043261068 PECOS PAC ID: 4981734506 Enrollment ID: I20100608000917 |
Provider Name | Jonathan S Cross |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1336146927 PECOS PAC ID: 0749325637 Enrollment ID: I20100809001104 |
Provider Name | Seth Craig Tarras |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1932140902 PECOS PAC ID: 1052581295 Enrollment ID: I20110826000487 |
Provider Name | Tatyana Dubrovsky |
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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 |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1144422502 PECOS PAC ID: 3577622141 Enrollment ID: I20140312001110 |
Provider Name | Joshuae German Gallardo |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1689985962 PECOS PAC ID: 7012134851 Enrollment ID: I20140819000324 |
Provider Name | Madiley Broz |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1790174563 PECOS PAC ID: 4284952029 Enrollment ID: I20150416002237 |
Provider Name | Maike T Blaya |
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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 |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104235340 PECOS PAC ID: 4587971288 Enrollment ID: I20150914000197 |
Provider Name | Susanne Gonzalez Gallardo |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1609192814 PECOS PAC ID: 5890004113 Enrollment ID: I20151027001198 |
Provider Name | Jada Caridad Santos |
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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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