MEDICARE: CORAL SPRINGS PEDIATRIC & ADULT PSYCHIATRY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	ME88032	FL

General Provider Information

NPI Number	:	1427592930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORAL SPRINGS PEDIATRIC & ADULT PSYCHIATRY, INC.

Provider Business Mailing Address
First Line	:	2844 N UNIVERSITY DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-1425
Country	:	US
Telephone Number	:	944-753-4888
Fax Number	:

Provider Business Practice Location Address
First Line	:	2844 N UNIVERSITY DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-1425
Country	:	US
Telephone Number	:	944-753-4888
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BRETT NEGIN
Credential	:	M.D.
Telephone Number	:	954-753-4888

Provider Enumeration Date	:	12/19/2016
Last Update Date	:	12/19/2016

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