MEDICARE: NEUROLOGY TESTING SERVICES, INC.

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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center
2	246ZE0600X	Electroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number	:	1285994913
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROLOGY TESTING SERVICES, INC.

Provider Business Mailing Address
First Line	:	1966 W NEW HAMPSHIRE ST
Second Line	:	SUITE E
City	:	ORLANDO
State	:	FL
Zip	:	32804-6023
Country	:	US
Telephone Number	:	407-894-6998
Fax Number	:

Provider Business Practice Location Address
First Line	:	1966 W NEW HAMPSHIRE ST
Second Line	:	SUITE E
City	:	ORLANDO
State	:	FL
Zip	:	32804-6023
Country	:	US
Telephone Number	:	321-436-2027
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KIRK TAYLOR BANKS
Credential	:
Telephone Number	:	321-436-2027

Provider Enumeration Date	:	05/29/2012
Last Update Date	:	05/29/2012

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