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Organization

THE BRAIN SPA, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDWARD LEONARDO BARIAS MD (MEDICAL DIRECTOR/OWNER)
(561) 406-6561
Entity
Organization

Contact information

Practice address
210 JUPITER LAKES BLVD STE 3102, JUPITER, FL 33458
(561) 406-6561
(561) 406-6629
Mailing address
210 JUPITER LAKES BLVD STE 3102, JUPITER, FL 33458-7189
(561) 406-6561
(561) 406-6629

Taxonomy

Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
ME119718
FL

Other

Enumeration date
06/27/2018
Last updated
08/30/2018
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