MEDICARE: VIRTUAL NEUROLOGY KANSAS, 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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1942922687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRTUAL NEUROLOGY KANSAS, LLC

Provider Business Mailing Address
First Line	:	9110 COLLEGE POINTE CT
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3244
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9110 COLLEGE POINTE CT
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3244
Country	:	US
Telephone Number	:	239-208-2212
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MOHAMMED ZAMAN
Credential	:	DO
Telephone Number	:	239-208-2212

Provider Enumeration Date	:	09/19/2022
Last Update Date	:	09/19/2022

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