Healthcare Provider Details

I. General information

NPI: 1962844043
Provider Name (Legal Business Name): RURAL NEUROLOGY FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2013
Last Update Date: 07/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 COUNTRY LANDING BLVD
APOPKA FL
32703-5020
US

IV. Provider business mailing address

230 COUNTRY LANDING BLVD
APOPKA FL
32703-5020
US

V. Phone/Fax

Practice location:
  • Phone: 321-527-1178
  • Fax: 407-703-5541
Mailing address:
  • Phone: 321-527-1178
  • Fax: 407-703-5541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberEXEMPT-NONPROFIT
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License NumberEXEMPT-NONPROFIT
License Number StateFL

VIII. Authorized Official

Name: MR. BRIAN MERRITT
Title or Position: DIRECTOR
Credential: RPSGT, RST, CET
Phone: 321-527-1178