Healthcare Provider Details

I. General information

NPI: 1437918372
Provider Name (Legal Business Name): PIONEER NEUROHEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2024
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5812 OLD PASCO RD
WESLEY CHAPEL FL
33544-4011
US

IV. Provider business mailing address

13067 N TELECOM PKWY
TEMPLE TERRACE FL
33637-0926
US

V. Phone/Fax

Practice location:
  • Phone: 813-333-9108
  • Fax: 813-333-9395
Mailing address:
  • Phone: 813-779-6303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SYED IRFAN ALI
Title or Position: OWNER
Credential: MD
Phone: 813-779-6303