Provider Demographics
NPI:1083618649
Name:BROOKWOOD FLORIDA - EAST, INC.
Entity Type:Organization
Organization Name:BROOKWOOD FLORIDA - EAST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:MESMER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMHC
Authorized Official - Phone:727-822-4789
Mailing Address - Street 1:11461 NW 43RD ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-7180
Mailing Address - Country:US
Mailing Address - Phone:727-822-4789
Mailing Address - Fax:727-896-4475
Practice Address - Street 1:11461 NW 43RD ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-7180
Practice Address - Country:US
Practice Address - Phone:727-822-4789
Practice Address - Fax:727-896-4475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness