Healthcare Provider Details

I. General information

NPI: 1821647769
Provider Name (Legal Business Name): NEUROCLINICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2019
Last Update Date: 05/03/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 SW 93RD AVE STE 210
MIAMI FL
33173-3212
US

IV. Provider business mailing address

7300 SW 93RD AVE STE 210
MIAMI FL
33173-3212
US

V. Phone/Fax

Practice location:
  • Phone: 786-383-0173
  • Fax: 307-242-1124
Mailing address:
  • Phone: 786-383-0173
  • Fax: 307-242-1124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROMER ISAAC MOSQUERA
Title or Position: OWNER
Credential: M.D.
Phone: 307-622-7725