Healthcare Provider Details

I. General information

NPI: 1053246207
Provider Name (Legal Business Name): INTERVENTIONAL NEURO ASSOCIATES FLORIDA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S 23RD ST
FORT PIERCE FL
34950-4803
US

IV. Provider business mailing address

43 WESTMINSTER AVE
BERGENFIELD NJ
07621-3913
US

V. Phone/Fax

Practice location:
  • Phone: 201-387-1957
  • Fax:
Mailing address:
  • Phone: 201-387-1957
  • Fax: 201-351-0656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY FARKAS
Title or Position: OWNER
Credential: MD
Phone: 201-387-1957