Healthcare Provider Details

I. General information

NPI: 1497172803
Provider Name (Legal Business Name): NEUROINTERNATIONAL HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2014
Last Update Date: 06/15/2025
Certification Date: 06/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 FRUITVILLE RD
SARASOTA FL
34232-1617
US

IV. Provider business mailing address

280 MERRIMACK ST STE 600
LAWRENCE MA
01843-1779
US

V. Phone/Fax

Practice location:
  • Phone: 703-342-9316
  • Fax:
Mailing address:
  • Phone: 703-342-9316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License NumberAL7221
License Number StateFL

VIII. Authorized Official

Name: MARY PATRICIA RODENBERG-ROBERTS
Title or Position: VP & SR ASST GENERAL COUNSEL
Credential:
Phone: 952-836-2234