Healthcare Provider Details

I. General information

NPI: 1023815628
Provider Name (Legal Business Name): BIRMINGHAM FUNCTIONAL NEUROLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2025
Last Update Date: 03/01/2025
Certification Date: 03/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 PRINCETON AVE SW STE 112
BIRMINGHAM AL
35211-1340
US

IV. Provider business mailing address

817 PRINCETON AVE SW STE 112
BIRMINGHAM AL
35211-1340
US

V. Phone/Fax

Practice location:
  • Phone: 205-882-1348
  • Fax: 205-882-1348
Mailing address:
  • Phone: 205-882-1348
  • Fax: 205-882-1348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BRANDON B. ARRIETA
Title or Position: OWNER/FUNCTIONAL NEUROLOGIST
Credential: MS, DC, DACNB
Phone: 205-882-1348