Healthcare Provider Details

I. General information

NPI: 1801273883
Provider Name (Legal Business Name): NEUROVASCULAR INSTITUTE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 04/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10904 MYRTLE OAK CT
PALM BEACH GARDENS FL
33410-3287
US

IV. Provider business mailing address

10904 MYRTLE OAK CT
PALM BEACH GARDENS FL
33410-3287
US

V. Phone/Fax

Practice location:
  • Phone: 561-252-0943
  • Fax: 561-627-6734
Mailing address:
  • Phone: 561-252-0943
  • Fax: 561-627-6734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number11783
License Number StateFL

VIII. Authorized Official

Name: DR. CATHERINE PLISCOF HOLWAY
Title or Position: OWNER
Credential: PT, DPT
Phone: 561-252-0943