DR. BRODY LLC (NPI# 1780072512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780072512 |
| Entity Type | Organization |
| Organization Name | DR. BRODY LLC |
| Practice Address |
871 Sw State Road 47 Lake City FL 32025-0433 |
| Practice Telephone | 3867551720 |
| Practice Fax Number | 3867541325 |
| Mailing Telephone | 3867551720 |
| Mailing Fax Number | 3867541325 |
| Enumeration Date | 2015-01-01 |
| Last Update Date | 2016-05-04 |
| Authorized Official Name | BARRY BRODY (OWNER) |
| Authorized Official Telephone | 3867551720 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
MT983 | FL | Ambulatory Health Care Facilities |
| Street Address |
871 SW STATE ROAD 47 |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32025-0433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114935830 | Melanie M Nelson | Psychologist | 871 Sw State Road 47, Lake City, FL 32025-0433 | 2006-08-05 |
| 1598154668 | Kimberly Carpenter Herring, L.L.C. | Social Worker | 871 Sw State Road 47, Lake City, FL 32025-0433 | 2015-01-13 |
| 1831494319 | Daisy J Tomassini | Speech-Language Pathologist | 871 Sw State Road 47, Lake City, FL 32025-0433 | 2011-01-14 |
| 1508170838 | Kimberly Carpenter Herring | Social Worker | 871 Sw State Road 47, Lake City, FL 32025-0433 | 2010-07-28 |
| 1194053249 | Colleen Hamilton | Registered Nurse | 871 Sw State Road 47, Lake City, FL 32025-0433 | 2009-12-01 |
| 1841384948 | Andres R Villar Md | Counselor | 871 Sw State Road 47, Lake City, FL 32025-0433 | 2006-10-03 |
| 1376638775 | Barry Brody | Marriage & Family Therapist | 871 Sw State Road 47, Lake City, FL 32025-0433 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801438353 | Jennifer Bennett | Pharmacist | 347 Sw Main Blvd Suite 102, Lake City, FL 32025 | 2019-10-16 |
| 1700352838 | Robert J Sansouci IIi IIi | Physical Therapy Assistant | 560 Sw Mcfarlane Ave, Lake City, Fl, 32025, Lake City, FL 32025 | 2018-10-16 |
| 1316442783 | Emily Bailey | Developmental Therapist | 2126 Sw Sisters Welcome Rd, Lake City, FL 32025 | 2018-03-28 |
| 1811446370 | Michelle Hart | Behavioral Analyst | 260 S. Marion Avenue, Bldg. A, Suite 135, Lake City, FL 32025 | 2016-09-26 |
| 1922467646 | Irene Aponte Moreno | Nurse Practitioner | 440 Sw Perimeter Glen, Lake City, FL 32025 | 2016-02-23 |
| 1093186777 | Decarlos Scippio | Counselor | 619 Sw Baya Drive Suite 102, Lake City, FL 32025 | 2015-10-07 |
| 1497132476 | Jamecia Legree | Registered Nurse | 800 Sw Symphony Loop, Bldg 15 Apt 204, Lake City, FL 32025 | 2015-04-29 |
| 1306249149 | Mercy Home Assisted Living Facility LLC | Assisted Living Facility | 184 S.e. Beech Street, Lake City, FL 32025 | 2014-10-08 |
| 1598174344 | Karen Mcdonald | Developmental Therapist | 4523 Se County Road 252, Lake City, FL 32025 | 2014-08-06 |
| 1275944126 | Mohammad Ali Faisal Mdpa | Specialist | 1283 Sw State Rd 47, Ste 104, Lake City, FL 32025 | 2014-05-14 |
| Find all providers in zip 32025 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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|---|---|---|---|---|
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| 1043636046 | Pee Dee Mental Health | Clinic/Center | 675 N Matthews Rd, Lake City, SC 29560-7027 | 2014-03-14 |
| 1427396845 | North Central Iowa Mental Health Center Inc | Clinic/Center | 1301 W Main St, Lake City, IA 51449-1585 | 2013-01-18 |
| 1588926448 | North Central Iowa Mental Health Center, Inc | Clinic/Center | 1890 E Main St, Lake City, IA 51449-7706 | 2012-06-15 |
| 1689846859 | Meridian Behavioral Healthcare, Inc of Lake City | Clinic/Center | 439 Sw Michigan St, Lake City, FL 32025-0440 | 2008-03-28 |
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| 1790385342 | New Family Wellness Center Inc | Clinic/Center | 8200 Nw 41st St Ste 200-98, Doral, FL 33166-6205 | 2020-10-31 |
| 1619577475 | Prestige Behavioral Health Center, LLC | Clinic/Center | 7318 W 20th Ave, Hialeah, FL 33016-1855 | 2020-10-29 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.