RADIUS TBI OF SOUTH FLORIDA (NPI# 1558886069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558886069 |
| Entity Type | Organization |
| Organization Name | RADIUS TBI OF SOUTH FLORIDA |
| Other Organization Name | RADIUS TBI |
| Practice Address |
4330 W Broward Blvd Ste G Plantation FL 33317-3753 |
| Practice Telephone | (954) 598-0779 |
| Mailing Telephone | 9545980779 |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2017-08-04 |
| Authorized Official Name | BRIAN MEVORAH (CEO) |
| Authorized Official Telephone | 9544712133 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers | ||
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| N | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers | ||
| Y | 2084P0301X |
Psychiatry & Neurology Specialization: Brain Injury Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | NPI | 1346605011 | 01 |
| Other Name | Type Code |
|---|---|
| Radius TBI | Doing Business As Name - Organization |
| Street Address |
4330 W BROWARD BLVD STE G |
| City | PLANTATION |
| State | FL |
| Zip Code | 33317-3753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437704434 | Md Now Medical Centers Inc | Clinic/Center | 4640 W Commercial Blvd, Tamarac, FL 33317 | 2019-08-06 |
| 1902348675 | Atroypen Group, Inc | Case Management | 4330 W Broward Blvd Ste R, Plantation, FL 33317 | 2016-11-13 |
| 1417329665 | Marie Eronne Jean Charles | Nurse Practitioner | 6901 Cypress Road, Plantation, FL 33317 | 2015-10-28 |
| 1871977025 | Yanliceth Rodriguez | Clinic/Center | 4430 Sw 22nd Ct, Ft Lauderdale, FL 33317 | 2015-07-17 |
| 1710361472 | Melissa Coffman | Physician Assistant | 960 Sw 74th Avenue, Plantation, FL 33317 | 2015-07-13 |
| 1134511058 | Emad Ziaden | Physical Therapist | 747 S. State Rd 7, Plantation, FL 33317 | 2015-03-02 |
| 1760880710 | Michael Robert Tanguay | Orthotist | 450 North State Road 7, Plantation, FL 33317 | 2014-12-08 |
| 1821427675 | Mankame, Dipak M., D.d.s., P.a. | Dentist | 300 N.w. 70th Ave Suite 109, Plantation, FL 33317 | 2013-11-02 |
| 1679828826 | Kozy Kove Assisted Living Facility | Assisted Living Facility | 490 Nw 45 Terr, Plantation, FL 33317 | 2012-07-13 |
| 1205102845 | Aratha Franklin Dixon | Psychologist | 4121 Nw 5th # 207, Plantation, FL 33317 | 2012-03-28 |
| Find all providers in zip 33317 | ||||
| Taxonomy Code | 2084P0301X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Brain Injury Medicine |
| A Brain Injury Medicine physician specializes in disorders of brain function due to injury and disease. These disorders encompass a range of medical, physical, neurologic, cognitive, sensory, and behavioral disorders that result in psychosocial, educational, and vocational consequences. |
| Notes: Source: American Board of Physical Medicine and Rehabilitation, 2015. www.abpmr.org [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003431396 | Traumatic Brain Diagnostic, LLC | Psychiatry & Neurology | 1814 Wellness Ln, Trinity, FL 34655-5357 | 2020-06-11 |
| City | PLANTATION |
| Zip Code | 33317 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.