53RD STREET MEDICAL GROUP, LLC – NPI #1962767202
Psychiatry & Neurology

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine

Health Care Provider Taxonomy Code for Psychiatry & Neurology

53RD STREET MEDICAL GROUP, LLC is a psychiatry & neurologist located in FORT LAUDERDALE, FL. NPPES has assigned the NPI number 1962767202 to 53RD STREET MEDICAL GROUP, LLC on July 12, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2084A0401X from the Health Care Provider Taxonomy code set, which is classified as Psychiatry & Neurology, specializing in Addiction Medicine

The NPI profile was previously updated about 14 years ago on Aug 01, 2012. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for 53RD STREET MEDICAL GROUP, LLC below.

NPI Profile for
53RD STREET MEDICAL GROUP, LLC

NPI Number
1962767202
Enumeration Date

(about 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
53RD STREET MEDICAL GROUP, LLC
Primary location
2331 NE 53RD ST
FORT LAUDERDALE, FL 33308-3235
Phone: (954) 491-9700 Fax:
Mailing address
PO BOX 7240
JUPITER, FL 33468-7240
Phone: (561) 748-2889 Fax: (561) 748-1523
Organization Subpart
No
Authorized Official
KAREN BARLOW
PRESIDENT, JUPITER PROFESSIONAL DEV
Phone: (561) 748-2889
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2084A0401X
- Psychiatry & Neurology / Addiction Medicine (Primary)		 FL ME83014

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.