| Entity Name: | BROWARD NEUROSURGEONS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Sep 2002 (22 years ago) |
| Document Number: | L02000024910 |
| FEI/EIN Number | 030485325 |
| Address: | ONE PARK PLAZA, NASHVILLE, TN, 37203, US |
| Mail Address: | P.O. BOX 750, LEGAL DEPT., NASHVILLE, TN, 37202-0750, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366499618 | 2006-05-30 | 2017-10-17 | 8251 W BROWARD BLVD, SUITE 300, PLANTATION, FL, 333242703, US | 8251 W BROWARD BLVD, SUITE 300, PLANTATION, FL, 333242703, US | |||||||||||||||||||||||||
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| Phone | +1 954-475-9244 |
| Fax | 9544750848 |
Authorized person
| Name | WILLIAM TEDRICK JOHNSON |
| Role | VICE PRESIDENT |
| Phone | 6153723375 |
Taxonomy
| Taxonomy Code | 207T00000X - Neurological Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD |
| Number | DA0753 |
| Issuer | BLUE CROSS/BLUE SHIELD OF |
| Number | 34411 |
| State | FL |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| FRANCK II JOHN M | Manager | ONE PARK PLAZA, NASHVILLE, TN, 37203 |
| Cuffe Michael S | Manager | 2000 HealthPark Drive, Brentwood, TN, 37027 |
| WYATT CHRISTOPHER F | Manager | ONE PARK PLAZA, NASHVILLE, TN, 37203 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000114828 | HCA FLORIDA HEAD & NECK SURGICAL SPECIALISTS | ACTIVE | 2022-09-13 | 2027-12-31 | No data | ONE PARK PLAZA, LEGAL DEPT., NASHVILLE, TN, 37203 |
| G21000077442 | HCA FLORIDA NEUROSURGICAL SPECIALISTS | ACTIVE | 2021-06-09 | 2026-12-31 | No data | ONE PARK PLAZA, LEGAL DEPT., NASHVILLE, TN, 37203 |
| G17000046062 | NEUROSURGICAL SPECIALISTS OF SOUTH FLORIDA | EXPIRED | 2017-04-27 | 2022-12-31 | No data | ONE PARK PLAZA, LEGAL DEPT., NASHVILLE, TN, 37203 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
