Provider Demographics
NPI:1427075373
Name:NEUROBEHAVIORAL HEALTH INSTITUTE INC
Entity type:Organization
Organization Name:NEUROBEHAVIORAL HEALTH INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:
Authorized Official - Last Name:DILEONARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-321-1980
Mailing Address - Street 1:400 NW 74TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1618
Mailing Address - Country:US
Mailing Address - Phone:954-321-1980
Mailing Address - Fax:954-321-0747
Practice Address - Street 1:400 NW 74TH AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1618
Practice Address - Country:US
Practice Address - Phone:954-321-1980
Practice Address - Fax:954-321-0747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4518103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2244Medicare PIN