Provider Demographics
NPI:1982996724
Name:MIRAMAR HEALTH PHYSICIANS GROUP
Entity Type:Organization
Organization Name:MIRAMAR HEALTH PHYSICIANS GROUP
Other - Org Name:BRAIN THERAPY TMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-370-0771
Mailing Address - Street 1:400 ALTON ROAD
Mailing Address - Street 2:TH-4A
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139
Mailing Address - Country:US
Mailing Address - Phone:949-370-0771
Mailing Address - Fax:866-675-5593
Practice Address - Street 1:1539 GARNETT AVE.
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109
Practice Address - Country:US
Practice Address - Phone:619-762-4632
Practice Address - Fax:866-675-5593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-12
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty