Provider Demographics
NPI:1962716506
Name:COMPREHENSIVE NEUROBEHAVIORAL INSTITUTE PLLC
Entity type:Organization
Organization Name:COMPREHENSIVE NEUROBEHAVIORAL INSTITUTE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED NEUROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-587-4300
Mailing Address - Street 1:PO BOX 120068
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33312-0002
Mailing Address - Country:US
Mailing Address - Phone:954-587-4300
Mailing Address - Fax:954-587-4018
Practice Address - Street 1:4302 W BROWARD BLVD
Practice Address - Street 2:SUITE 800
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-3780
Practice Address - Country:US
Practice Address - Phone:954-587-4300
Practice Address - Fax:954-587-4018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-05
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4086111N00000X
FLME419822084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty