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General NPI Number Information
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NPI Number | 1114898723
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Entity Type | Organization
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Legal Business Name | BRAINWAVE SOLUTIONS, LLC
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Dates
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Enumeration Date | 09/16/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 2550 N FEDERAL HWY STE 4
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City | FORT LAUDERDALE
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State | FL
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Zip | 33305-1621
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Country | US
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Telephone | 954-284-3935
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Fax |
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Provider Business Mailing Address
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Address Line | 2550 N FEDERAL HWY STE 4
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City | FORT LAUDERDALE
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State | FL
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Zip | 33305-1621
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Country | US
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Telephone | 954-284-3935
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ERIC WEED
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Credential |
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Telephone | 405-441-9452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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