Child Neurology LLC

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

ME70907 Issued in FL

Legal business name

CHILD NEUROLOGY LLC

Practice address

4440 Sheridan Street
Hollywood, FL 33021

Phone

(954) 961-2423

Fax

(954) 961-4860

NPI assigned

May 31, 2006

Last updated

May 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tatyana Dubrovsky, MD

Title

Manager of the Child Neurology LLC

Phone

(954) 961-2423

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1710924956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 SHERIDAN STREET",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-961-2423",
            "fax_number": "954-961-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 SHERIDAN STREET",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-961-2423",
            "fax_number": "954-961-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD NEUROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "DUBROVSKY",
        "authorized_official_first_name": "TATYANA",
        "authorized_official_title_or_position": "MANAGER OF THE CHILD NEUROLOGY LLC",
        "authorized_official_telephone_number": "954-961-2423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "FL",
            "license": "ME70907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "77841",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDIATRIC ASSOCIATES PSN",
            "identifier": "276469500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL NETPASS",
            "identifier": "276469500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276469500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl a. Luis, PHD, Abpp-CN, PA
• Justin Lee Chevere, OT
• Isidora Paz Chevesich
• Kunnee Chew, LMT
• Nancy Chiang, MD
• Children's Diagnostic Testing Group of Broward, Inc.
• Childrens Center for Gastroenterology & Nutrition, PA
• Childrens Hearing Associates Inc
• Childrens Medical Center
• Mark Derrick Chin-Lenn, M.D.

• Neurology with Special Qualifications in Child Neurology Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.