Broward Physical Medicine

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

BROWARD PHYSICAL MEDICINE

Doing business as

South Florida Spine and Rehab Centers

Practice address

2121 W Oakland Park Blvd
Suit 10B
Oakland Park, FL 33311-1529

Phone

(954) 617-1011

NPI assigned

Aug 21, 2014

Last updated

Aug 21, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ryan A. Grand, D.C.NPI 1477788024

Title

Presidnet

Phone

(561) 729-7092

Specialties & licenses 1

Addresses

Other names 1

• South Florida Spine and Rehab Centers Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Alexandre Grand, D.C.

  • Chiropractor
  • West Palm Beach, FL
  • NPI 1477788024
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1033518436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15888",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334165888",
            "telephone_number": "561-729-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 W OAKLAND PARK BLVD",
            "address_2": "SUIT 10B",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333111529",
            "telephone_number": "954-617-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWARD PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "GRAND",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDNET",
        "authorized_official_telephone_number": "561-729-7092",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Florida Spine and Rehab Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bright Star Pediatric Therapy LLC
• Nicolette Samantha Bromfield, M.S.
• Roxanne Ramona Bromfield, APRN
• Andrea S. Brooks, M.A., CCC/A
• Broward County Elderly and Veterans Services Division
• Broward Rehab Center, Inc.
• Tanisha Brown McAlister, APRN
• Kerry Ann Brown-Faison, LCSW
• Barbara Viola Brown, RPT
• Jermaine Brown

• Chiropractor in Oakland Park, FL
• Providers in Oakland Park, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.