Organization
BROWARD NEUROSURGEONS LLC
Active
Parent organization
BROWARD NEUROSURGEONS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BROWARD NEUROSURGEONS LLC
Authorized official
WILLIAM TEDRICK JOHNSON (VICE PRESIDENT)
(615) 372-3375
Entity
Organization
Contact information
Practice address
8251 W BROWARD BLVD, SUITE 300, PLANTATION, FL 33324-2703
(954) 475-9244
(954) 475-0848
Mailing address
8251 W BROWARD BLVD, SUITE 300, PLANTATION, FL 33324-2703
(954) 475-9244
(954) 475-0848
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34411
BLUE CROSS/BLUE SHIELD OF
FL
01
—
DA0753
RAILROAD
—
Enumeration date
05/30/2006
Last updated
10/17/2017
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