Healthcare Provider Details

I. General information

NPI: 1801519616
Provider Name (Legal Business Name): NEUROPATHY GLOBAL 001
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2191 9TH AVE N STE 150
ST PETERSBURG FL
33713-7146
US

IV. Provider business mailing address

7901 4TH ST N STE 10810
ST PETERSBURG FL
33702-4305
US

V. Phone/Fax

Practice location:
  • Phone: 888-958-5343
  • Fax: 888-958-5343
Mailing address:
  • Phone: 888-958-5343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RHODERICK JAMES MANHATTAN
Title or Position: CEO
Credential: MSPAC
Phone: 888-958-5343