Healthcare Provider Details

I. General information

NPI: 1285994913
Provider Name (Legal Business Name): NEUROLOGY TESTING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2012
Last Update Date: 05/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1966 W NEW HAMPSHIRE ST SUITE E
ORLANDO FL
32804-6023
US

IV. Provider business mailing address

1966 W NEW HAMPSHIRE ST SUITE E
ORLANDO FL
32804-6023
US

V. Phone/Fax

Practice location:
  • Phone: 321-436-2027
  • Fax:
Mailing address:
  • Phone: 407-894-6998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. KIRK TAYLOR BANKS
Title or Position: PRESIDENT
Credential:
Phone: 321-436-2027