Healthcare Provider Details

I. General information

NPI: 1609826296
Provider Name (Legal Business Name): SOUTH FLORIDA NEUROLOGY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 12/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CLINT MOORE RD SUITE 120
BOCA RATON FL
33487-2768
US

IV. Provider business mailing address

1601 CLINT MOORE RD SUITE 120
BOCA RATON FL
33487
US

V. Phone/Fax

Practice location:
  • Phone: 561-939-0300
  • Fax: 561-939-0339
Mailing address:
  • Phone: 561-939-0300
  • Fax: 561-939-0339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. ROY C KATZIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 561-939-0300