Organization · Type 2 NPI

South Broward Hospital District

Clinical Neuropsychologist · Hollywood, FL

NPI number 1245656792 Active

Practice location

3600 Washington St Ste 311
Hollywood, FL 33021-8216

Call (954) 518-5507 Map

Fax (954) 518-5510

Mailing address

2900 Corporate Way, Door D
Miramar, FL 33025-3925

Specialties and licenses

Taxonomy	Code	License
Clinical Neuropsychologist Primary	103G00000X	None listed

Clinical Neuropsychologist: A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

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NPI record

NPI: 1245656792
Entity type: Organization (Type 2)
Issued: Mar 7, 2014
Last updated: Jun 20, 2023
Status: Active
Subpart: Yes of South Broward Hospital District

Other names

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Memorial Division of Rehabilitative Psychology · doing business as

Authorized official

Esther Surujon
CFO Memorial Physician Group & MPC
(954) 265-6677

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1245656792

South Broward Hospital District's National Provider Identifier is 1245656792, issued on Mar 7, 2014. The primary taxonomy on file is Clinical Neuropsychologist (103G00000X), and the practice location is in Hollywood, FL. The record was last updated on Jun 20, 2023.