Healthcare Provider Details

I. General information

NPI: 1336808567
Provider Name (Legal Business Name): VIRTUAL NEUROLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2021
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11215 METRO PKWY STE 1
FORT MYERS FL
33966-1206
US

IV. Provider business mailing address

11215 METRO PKWY STE 1
FORT MYERS FL
33966-1206
US

V. Phone/Fax

Practice location:
  • Phone: 239-208-2206
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: MOHAMMED ZAMAN
Title or Position: OWNER
Credential: DO
Phone: 239-220-2212