Healthcare Provider Details

I. General information

NPI: 1801732003
Provider Name (Legal Business Name): BRICK ROAD HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10350 W BAY HARBOR DR APT 8C
BAY HARBOR ISLANDS FL
33154-1258
US

IV. Provider business mailing address

10350 W BAY HARBOR DR APT 8C
BAY HARBOR ISLANDS FL
33154-1258
US

V. Phone/Fax

Practice location:
  • Phone: 954-247-1728
  • Fax: 844-799-0072
Mailing address:
  • Phone: 954-247-1728
  • Fax: 844-799-0072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELLIOT NUSSBAUM
Title or Position: FOUNDER/ CEO
Credential: PA
Phone: 954-247-1728