NPIMap

Organization Active NPI

Broward Institute of Neuro Science L L C

  • Psychiatry Physician
  • Coral Springs, FL
National Provider Identifier
1245429463
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BROWARD INSTITUTE OF NEURO SCIENCE L L C
Practice address
7501 Wiles Rd Ste 105
Coral Springs, FL 33067-2063
Phone
(954) 341-1022
Fax
(954) 341-1082
NPI assigned
Oct 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Authorized official

Name
Ricardo K Espaillat, MDNPI 1700838372
Title
Clinical Director/Chairman
Phone
(954) 341-1022

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prescribing (Medical) PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TP0016X BE8849854 FL
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

7501 Wiles Rd Ste 105
Coral Springs, FL 33067-2063

Mailing address

7501 Wiles Rd Ste 105
Coral Springs, FL 33067-2063
Phone (954) 341-1022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080424000724 FL Part B Supplier - Clinic/Group Practice 0547348997 Receives reassigned benefits from 2 practitioners
Practice locations: Coral Springs, FL

National Provider Directory

National Provider Directory
Tax ID family
Broward Institute of Neuro Science L L C3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7501 Wiles Rd
Ste 202
Coral Springs, FL 33067
Phone (954) 341-1022

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636070400000",
    "number": "1245429463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 WILES RD STE 105",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330672063",
            "telephone_number": "954-341-1022",
            "fax_number": "954-341-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 WILES RD STE 105",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330672063",
            "telephone_number": "954-341-1022",
            "fax_number": "954-341-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWARD INSTITUTE OF NEURO SCIENCE L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A",
        "authorized_official_last_name": "ESPAILLAT",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/CHAIRMAN",
        "authorized_official_telephone_number": "954-341-1022",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "FL",
            "license": "BE8849854",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.