1881665321 NPI number — INTERNATIONAL INSTITUTE OF SLEEP, INC.

Table of content: BROOKE JULIETTE ELLIS OTD, OTR/L (NPI 1871253286)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881665321 NPI number — INTERNATIONAL INSTITUTE OF SLEEP, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTERNATIONAL INSTITUTE OF SLEEP, INC.
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:
6
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:
1881665321
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/05/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2151 W HILLSBORO BLVD STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DEERFIELD BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33442-1107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-481-8467
Provider Business Mailing Address Fax Number:
954-427-8744

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2151 W HILLSBORO BLVD STE 110
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DEERFIELD BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33442-1107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-481-8467
Provider Business Practice Location Address Fax Number:
954-426-8744
Provider Enumeration Date:
02/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BECKER
Authorized Official First Name:
GLENN
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT CEO
Authorized Official Telephone Number:
954-481-8467

Provider Taxonomy Codes

  • Taxonomy code: 261QS1200X , with the licence number:  HCC7218 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 293D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QS1200X , with the licence number: HCC6568 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: 1313038 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QS1200X , with the licence number: HCC4483 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: V3248 . This is a "BCBS - LAKE WORTH LOCATION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: R9487 . This is a "BCBS (DME PROVIDER ID)" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2420 . This is a "BCBS - DEERFIELD BEACH LOCATION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 284817 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V3245 . This is a "BCBS - PLANTATION LOCATION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 21452 . This is a "SOUTHCARE PPO" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2825834 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 031671700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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