Provider Demographics
NPI:1780732529
Name:NORTH BROWARD NEUROLOGY, P.A.
Entity type:Organization
Organization Name:NORTH BROWARD NEUROLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAJANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-539-2030
Mailing Address - Street 1:49 N FEDERAL HWY
Mailing Address - Street 2:SUITE 348
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-4304
Mailing Address - Country:US
Mailing Address - Phone:954-539-2030
Mailing Address - Fax:954-539-2035
Practice Address - Street 1:1725 N UNIVERSITY DR
Practice Address - Street 2:SUITE #425
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6089
Practice Address - Country:US
Practice Address - Phone:954-539-2030
Practice Address - Fax:954-539-2035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76337174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271697600Medicaid
FLF54992Medicare UPIN
FLK9782Medicare ID - Type Unspecified