1619764081 NPI number — BRAINWORKS NEURO SOLUTIONS LLC

Table of content: DR. DIANE L.S. HUNT MD (NPI 1073589701)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619764081 NPI number — BRAINWORKS NEURO SOLUTIONS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRAINWORKS NEURO SOLUTIONS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619764081
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/21/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10394 W SAMPLE RD # 201A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORAL SPRINGS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33065-3970
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10394 W SAMPLE RD # 201A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORAL SPRINGS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33065-3970
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-456-1404
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/21/2025

Additional Information

Authorized Official

Authorized Official Last Name:
ALI
Authorized Official First Name:
SADIA
Authorized Official Middle Name:
ANEES
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
630-456-1404

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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