Brainchem Center LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME0047939 Issued in FL

Legal business name

BRAINCHEM CENTER LLC

Practice address

204 Lake Harris Dr
Lakeland, FL 33813-2632

Phone

(863) 646-7733

Fax

(863) 646-7733

NPI assigned

May 24, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Evaristo Placedes Badiola, M.D.

Title

Managing Member

Phone

(863) 646-7733

Specialties & licenses 1

Addresses

Other names 1

• BRAINCHEM LLC Doing business as

Locations

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285689372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 LAKE HARRIS DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132632",
            "telephone_number": "863-646-7733",
            "fax_number": "863-646-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 LAKE HARRIS DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132632",
            "telephone_number": "863-646-7733",
            "fax_number": "863-646-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAINCHEM CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BADIOLA",
        "authorized_official_first_name": "EVARISTO",
        "authorized_official_middle_name": "PLACEDES",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "863-646-7733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME0047939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRAINCHEM LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kasey Hope Bradshaw, APRN-C
• Wendy Lea Bradshaw
• Mary E Brady, LPN
• Darrell Braham, DO
• Brain Matters Health Care
• Christina Brake, LPN
• Johanna Lea Branch, PTA
• Sonya Branch
• Joyce Ann Brandon, RN
• Rhett Kennedy Brandt, PH.D., LMHC, CAP

• Psychiatry Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.