Healthcare Provider Details

I. General information

NPI: 1083536478
Provider Name (Legal Business Name): EMERGENT NEUROSURGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E SAMPLE RD
DEERFIELD BEACH FL
33064-3502
US

IV. Provider business mailing address

P.O. BOX 9705258
COCONUT CREEK FL
33097-0528
US

V. Phone/Fax

Practice location:
  • Phone: 954-941-8300
  • Fax:
Mailing address:
  • Phone: 954-227-8224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JESSICA OKUN
Title or Position: MANAGING MEMBER
Credential: DO
Phone: 954-653-3722