Organization Active NPI

Larry Brooks, PH.D., LLC

  • Psychologist
  • Miami, FL
National Provider Identifier
1669716247
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY8127 Issued in FL
Legal business name
LARRY BROOKS, PH.D., LLC
Practice address
80 SW 8TH St Ste 2185
Miami, FL 33130-3004
Phone
(786) 303-1991
NPI assigned
Nov 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Authorized official

Name
Jose Flores
Title
Accounts Specialist
Phone
(754) 201-2265

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103G00000X PY8127 FL
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X PY8127 FL Primary

Addresses

Primary practice location

80 SW 8TH St Ste 2185
Miami, FL 33130-3004

Mailing address

3810 Hollywood Blvd Ste 2
Hollywood, FL 33021-6779
Phone (786) 303-1991

Other identifiers 1

IdentifierTypeStateIssuer
PY8127OtherFLDOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130109000142 FL Part B Supplier - Clinic/Group Practice 6608028899 Receives reassigned benefits from 2 practitioners
Practice locations: Hollywood, FL; South Miami, FL; Miami, FL

National Provider Directory

National Provider Directory

Locations

3810 Hollywood Blvd
Ste 2
Hollywood, FL 33021
Phone (954) 962-3888

80 SW 8th St
Ste 2185
Miami, FL 33130
Phone (305) 915-5748

8950 N Kendall Dr
Ste 104
Miami, FL 33176
Phone (305) 699-2503

7685 SW 104th St
Ste 100
Pinecrest, FL 33156
Phone (305) 666-8000

7701 SW 62nd Ave
Ste 201
South Miami, FL 33143
Phone (305) 699-2503

Practitioners & affiliated clinicians

Practitioners 5

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": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1669716247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 HOLLYWOOD BLVD STE 2",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216779",
            "telephone_number": "786-303-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SW 8TH ST STE 2185",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331303004",
            "telephone_number": "786-303-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY BROOKS, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "ACCOUNTS SPECIALIST",
        "authorized_official_telephone_number": "754-201-2265"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY8127",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY8127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOH",
            "identifier": "PY8127",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.