Bridge Disability Network, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT27161 Issued in FL

Legal business name

BRIDGE DISABILITY NETWORK, INC.

Practice address

500 N Park Rd
Hollywood, FL 33021-6905

Phone

(954) 894-9023

NPI assigned

May 13, 2014

Organization subpart

No

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

Authorized official

Name

Mary Ebanks-Nunaihed, DPT

Title

VP of Therapy Services

Phone

(954) 699-4690

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399939200000",
    "number": "1467863464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N PARK RD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216905",
            "telephone_number": "954-894-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N PARK RD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216905",
            "telephone_number": "954-894-9023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE DISABILITY NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-13",
        "last_updated": "2014-05-13",
        "status": "A",
        "authorized_official_last_name": "EBANKS-NUNAIHED",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "VP OF THERAPY SERVICES",
        "authorized_official_telephone_number": "954-699-4690",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "FL",
            "license": "SA10164",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "PT27161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008612500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002014300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brentwood Medical Supplies LLC
• Rosalyn Brewer, M.D./PH.D.
• Brian B Ibrahim MD PA
• Rafael Segundo Briceno, M.D.
• Gloria D Brickenden, M.A., OTR/L
• Bridge of Help Services
• Mark Wilson Bridges, M.D.
• Alexandra Fay Brier
• Scott Brietzke, MD
• Paul C. Briggs, MSW,LCSW,LICSW,LMT

• Physical Therapy Clinic/Center in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.