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General NPI Number Information
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NPI Number | 1962716506
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE NEUROBEHAVIORAL INSTITUTE PLLC
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Dates
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Enumeration Date | 08/05/2010
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Last Update Date | 06/14/2011
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Provider Practice Location Address
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Address Line | 4302 W BROWARD BLVD SUITE 800
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City | PLANTATION
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State | FL
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Zip | 33317-3780
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Country | US
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Telephone | 954-587-4300
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Fax | 954-587-4018
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Provider Business Mailing Address
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Address Line | PO BOX 120068
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City | PLANTATION
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State | FL
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Zip | 33312-0002
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Country | US
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Telephone | 954-587-4300
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Fax | 954-587-4018
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Authorized Official
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Title or Position | BOARD CERTIFIED NEUROLOGIST
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Name | DAVID B ROSS
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Credential | M.D
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Telephone | 954-587-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH4086
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME41982
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License Number State | FL
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