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General NPI Number Information
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NPI Number | 1821502071
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Entity Type | Organization
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Legal Business Name | NEUROHEALTH PROFESSIONALS OF FLORIDA LLC
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Dates
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Enumeration Date | 11/27/2017
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Last Update Date | 07/29/2018
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Provider Practice Location Address
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Address Line | 2455 HOLLYWOOD BLVD STE 208
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City | HOLLYWOOD
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State | FL
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Zip | 33020
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Country | US
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Telephone | 954-453-1101
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Fax | 954-453-1102
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Provider Business Mailing Address
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Address Line | 2455 HOLLYWOOD BLVD STE 208
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City | HOLLYWOOD
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State | FL
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Zip | 33020-6605
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Country | US
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Telephone | 954-453-1101
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Fax | 954-453-1102
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. KAREEM EDWARDS
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Credential | PSYD
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Telephone | 954-453-1101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY9183
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License Number State | FL
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