MEDICARE: NEUROORTHOGROUP, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center	ME59560	FL

General Provider Information

NPI Number	:	1043514953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROORTHOGROUP, PA

Provider Business Mailing Address
First Line	:	2901 W CYPRESS CREEK RD
Second Line	:	SUITE 123-124
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-1730
Country	:	US
Telephone Number	:	954-582-2260
Fax Number	:	954-582-2808

Provider Business Practice Location Address
First Line	:	2901 W CYPRESS CREEK RD
Second Line	:	SUITE 123-124
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-1730
Country	:	US
Telephone Number	:	954-582-2260
Fax Number	:	954-582-2808

Authorized Official
Title or Position	:	PVD
Name	:	DR. STEVEN GELBARD
Credential	:	M.D.
Telephone Number	:	954-582-2260

Provider Enumeration Date	:	01/06/2011
Last Update Date	:	01/06/2011

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