Provider Demographics
NPI:1609898725
Name:BROT, ENID (LCSW)
Entity type:Individual
Prefix:
First Name:ENID
Middle Name:
Last Name:BROT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2475 QUAIL ROOST DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-1434
Mailing Address - Country:US
Mailing Address - Phone:954-384-7358
Mailing Address - Fax:
Practice Address - Street 1:100 S PINE ISLAND RD
Practice Address - Street 2:SUITE 230
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2613
Practice Address - Country:US
Practice Address - Phone:954-370-2140
Practice Address - Fax:954-916-1252
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW20511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ3329ZMedicare PIN