MEDICARE: DR. MADILEY BROZ PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	PY-9219	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790174563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MADILEY BROZ PSY.D.

Provider Business Mailing Address
First Line	:	1800 SW 85TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-1015
Country	:	US
Telephone Number	:	305-469-5153
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 N 35TH AVE STE 590
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-5468
Country	:	US
Telephone Number	:	954-265-9500
Fax Number	:	954-265-1431

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2015
Last Update Date	:	06/08/2026

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