Healthcare Provider Details

I. General information

NPI: 1427713296
Provider Name (Legal Business Name): BROWARD INSTITUTE OF NEURO SCIENCE L L C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2021
Last Update Date: 09/06/2023
Certification Date: 11/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3219 W 4TH AVE
HIALEAH FL
33012-5308
US

IV. Provider business mailing address

7501 WILES RD STE 105
CORAL SPRINGS FL
33067-2063
US

V. Phone/Fax

Practice location:
  • Phone: 305-261-6633
  • Fax: 305-261-6680
Mailing address:
  • Phone: 954-346-8300
  • Fax: 954-341-1082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: RICARDO ESPAILLAT
Title or Position: MD/OWNER
Credential: MD
Phone: 954-346-8300