Organization Active NPI

MBR Wellness, LLC

  • Psychiatry Physician
  • Coral Springs, FL
National Provider Identifier
1467174730
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MBR WELLNESS, LLC
Practice address
3111 N University Dr Ste 705
Coral Springs, FL 33065-1411
Phone
(954) 675-4609
NPI assigned
Sep 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Authorized official

Name
Mr. Andrew J Rader
Title
Officer
Phone
(954) 675-4609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

3111 N University Dr Ste 705
Coral Springs, FL 33065-1411

Mailing address

3111 N University Dr Ste 705
Coral Springs, FL 33065-1411
Phone (954) 675-4609

National Provider Directory

National Provider Directory

Locations

3111 N University Dr
Ste 705
Coral Springs, FL 33065
Phone (954) 675-4609

Practitioners & affiliated clinicians

Practitioners 1

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": "1663113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1467174730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 N UNIVERSITY DR STE 705",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330651411",
            "telephone_number": "954-675-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 N UNIVERSITY DR STE 705",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330651411",
            "telephone_number": "954-675-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBR WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "RADER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "954-675-4609",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE 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 Sep 14, 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.