Provider Demographics
NPI:1427592930
Name:CORAL SPRINGS PEDIATRIC & ADULT PSYCHIATRY, INC.
Entity Type:Organization
Organization Name:CORAL SPRINGS PEDIATRIC & ADULT PSYCHIATRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:NEGIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-753-4888
Mailing Address - Street 1:2844 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-1425
Mailing Address - Country:US
Mailing Address - Phone:944-753-4888
Mailing Address - Fax:
Practice Address - Street 1:2844 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-1425
Practice Address - Country:US
Practice Address - Phone:944-753-4888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME880322084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty