Organization Active NPI

Neurocity Tbi, LLC

  • Neurology Physician
  • Davie, FL
National Provider Identifier
1528818838
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NEUROCITY TBI, LLC
Doing business as
Neurocity
Practice address
10650 W State Road 84 Ste 208
Davie, FL 33324-4235
Phone
(954) 279-2170
NPI assigned
Mar 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Marisa Merlo
Title
Accounts Receivable
Phone
(954) 279-2170

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Sports Physician ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NS0005X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary
Neurology Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251N0400X
Neurorehabilitation Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XN1300X

Addresses

Primary practice location

10650 W State Road 84 Ste 208
Davie, FL 33324-4235

Mailing address

817 S University Dr Ste 119
Plantation, FL 33324-3318
Phone (954) 424-9724

Other names 1

  • Neurocity Doing business as

National Provider Directory

National Provider Directory

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": "1711497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1528818838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 S UNIVERSITY DR STE 119",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243318",
            "telephone_number": "954-424-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10650 W STATE ROAD 84 STE 208",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333244235",
            "telephone_number": "954-279-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROCITY TBI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "MERLO",
        "authorized_official_first_name": "MARISA",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE",
        "authorized_official_telephone_number": "954-279-2170"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neurocity",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.