MEDICARE: ALL FLORIDA NEUROLOGY LLC

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	174400000X	Specialist	61113	FL

General Provider Information

NPI Number	:	1821233826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL FLORIDA NEUROLOGY LLC

Provider Business Mailing Address
First Line	:	5649 49TH ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33709-2105
Country	:	US
Telephone Number	:	727-528-2272
Fax Number	:	727-528-1437

Provider Business Practice Location Address
First Line	:	5649 49TH ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33709-2105
Country	:	US
Telephone Number	:	727-528-2272
Fax Number	:	727-528-1437

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. HARISH J PATEL
Credential	:	M.D.
Telephone Number	:	727-528-2272

Provider Enumeration Date	:	12/05/2008
Last Update Date	:	12/05/2008

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