Provider Demographics
NPI:1649009879
Name:FOCUS BRAIN THERAPY
Entity type:Organization
Organization Name:FOCUS BRAIN THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:HUSEBOE
Authorized Official - Suffix:
Authorized Official - Credentials:CH
Authorized Official - Phone:954-410-2999
Mailing Address - Street 1:10650 W STATE ROAD 84 STE 208
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4235
Mailing Address - Country:US
Mailing Address - Phone:754-778-8685
Mailing Address - Fax:954-208-9854
Practice Address - Street 1:10650 W STATE ROAD 84 STE 208
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-4235
Practice Address - Country:US
Practice Address - Phone:754-778-8685
Practice Address - Fax:954-208-9854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-27
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports MedicineGroup - Multi-Specialty