Healthcare Provider Details

I. General information

NPI: 1346154036
Provider Name (Legal Business Name): CUBS CORNER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9181 GLADES RD STE 120
BOCA RATON FL
33434-3940
US

IV. Provider business mailing address

9181 GLADES RD STE 120
BOCA RATON FL
33434-3940
US

V. Phone/Fax

Practice location:
  • Phone: 561-300-0591
  • Fax: 561-839-6563
Mailing address:
  • Phone: 561-300-0591
  • Fax: 561-839-6563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. BRETT BERNSTEIN
Title or Position: MANAGING PARTNER
Credential:
Phone: 301-830-3899