Provider Demographics
NPI:1356575245
Name:NEUROBRAIN DIAGNOSTIC, LTD
Entity type:Organization
Organization Name:NEUROBRAIN DIAGNOSTIC, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-985-5633
Mailing Address - Street 1:3475 SHERIDAN STREET
Mailing Address - Street 2:215E
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3659
Mailing Address - Country:US
Mailing Address - Phone:954-985-5633
Mailing Address - Fax:954-985-5634
Practice Address - Street 1:3475 SHERIDAN STREET
Practice Address - Street 2:215E
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3659
Practice Address - Country:US
Practice Address - Phone:954-985-5633
Practice Address - Fax:954-985-5634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service