Healthcare Provider Details

I. General information

NPI: 1700839453
Provider Name (Legal Business Name): NEUROLOGY& NEUROSURGERY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 09/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 2ND ST SE
WINTER HAVEN FL
33880-6300
US

IV. Provider business mailing address

50 2ND ST SE
WINTER HAVEN FL
33880-6300
US

V. Phone/Fax

Practice location:
  • Phone: 863-293-2100
  • Fax: 863-595-4227
Mailing address:
  • Phone: 863-293-2100
  • Fax: 863-595-4227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. JUAN L JOY
Title or Position: PRESIDENT
Credential: MD
Phone: 863-293-2100