Organization · Type 2 NPI

53rd Street Medical Group, LLC

Addiction Medicine (Psychiatry & Neurology) Physician · Fort Lauderdale, FL

NPI number 1962767202 Active

Practice location

2331 NE 53rd St
Fort Lauderdale, FL 33308-3235

Mailing address

PO Box 7240
Jupiter, FL 33468-7240

Specialties and licenses

TaxonomyCodeLicense
Addiction Medicine (Psychiatry & Neurology) Physician Primary 2084A0401XME83014 (FL)

Addiction Medicine (Psychiatry & Neurology) Physician: 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

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About NPI 1962767202

53rd Street Medical Group, LLC's National Provider Identifier is 1962767202, issued on Jul 12, 2012. The primary taxonomy on file is Addiction Medicine (Psychiatry & Neurology) Physician (2084A0401X), and the practice location is in Fort Lauderdale, FL. The record was last updated on Aug 1, 2012.