Healthcare Provider Details

I. General information

NPI: 1326298761
Provider Name (Legal Business Name): NEURODOC TESTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7805 NW BEACON SQUARE BLVD BLDG 5 SUITE 103
BOCA RATON FL
33487-1395
US

IV. Provider business mailing address

7805 NW BEACON SQUARE BLVD BLDG 5 SUITE 103
BOCA RATON FL
33487-1395
US

V. Phone/Fax

Practice location:
  • Phone: 561-620-0174
  • Fax:
Mailing address:
  • Phone: 561-620-0174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. RONALD BRODKIN
Title or Position: PRESIDENT
Credential: DC
Phone: 561-620-0174