Provider Demographics
NPI:1295203784
Name:NSI BROWARD LLC
Entity Type:Organization
Organization Name:NSI BROWARD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-400-0479
Mailing Address - Street 1:55 WESTON RD STE 101B
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1112
Mailing Address - Country:US
Mailing Address - Phone:954-659-1208
Mailing Address - Fax:954-960-6355
Practice Address - Street 1:55 WESTON RD STE 101B
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-1112
Practice Address - Country:US
Practice Address - Phone:954-659-1208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH11011OtherSTATE OF FLORIDA
FLME124453OtherSTATE OF FLORIDA
FLOS11815OtherSTATE OF FLORIDA
FLPA9104903OtherSTATE OF FLORIDA