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NPI Code Detail

MEDICARE: PHAROS GROUP, LLC

MEDICARE: PHAROS GROUP, LLC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1922525567
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHAROS GROUP, LLC
Provider Business Mailing Address
First Line : 2600 LAKE LUCIEN DR STE 210
Second Line :
City : MAITLAND
State : FL
Zip : 32751-7275
Country : US
Telephone Number : 954-284-0495
Fax Number :
Provider Business Practice Location Address
First Line : 1431 SW 9TH AVE
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-6220
Country : US
Telephone Number : 954-284-0495
Fax Number :
Authorized Official
Title or Position : CFO
Name : BENJAMIN BRADY
Credential :
Telephone Number : 615-864-8145
Provider Enumeration Date : 08/24/2017
Last Update Date : 04/06/2026

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