Tijay Broadnax, APD PROVIDER

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Practice address

1514 S Alexander St Ste 202
Plant City, FL 33563-8418

Phone

(813) 652-8119

NPI assigned

Jul 18, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Plus Care Health Options Inc

  • Home Health Aide
  • Plant City, FL
  • NPI 1538874052
  NPD

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1235864000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 S ALEXANDER ST STE 202",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335638418",
            "telephone_number": "813-652-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 S ALEXANDER ST STE 202",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335638418",
            "telephone_number": "813-652-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADNAX",
        "first_name": "TIJAY",
        "name_prefix": "Mr.",
        "credential": "APD PROVIDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-18",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Boully, PT
• Kimberly Lynn Boyett, D.D.S
• Stacey Breuggeman, PHARMD
• Adriana Brewer, MS, CCC-SLP
• Dalia Brito
• Brenda Kay Brogdon, ARNP
• Danielle Brown
• Destiny Terriona Brown
• Roy Webster Bruce Jr., O.D.
• Jeremy Brumley, M.S.

• Developmental Disabilities Clinic/Center in Plant City, FL
• Providers in Plant City, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.