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General NPI Number Information
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NPI Number | 1013367556
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Entity Type | Organization
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Legal Business Name | VERO BEACH NEUROLOGY AND RESEARCH INSTITUTE LLC
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Dates
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Enumeration Date | 06/15/2016
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Last Update Date | 02/06/2018
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Provider Practice Location Address
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Address Line | 1040 37TH PL SUITE 201
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City | VERO BEACH
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State | FL
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Zip | 32960-4806
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Country | US
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Telephone | 772-492-7051
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Fax |
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Provider Business Mailing Address
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Address Line | 1040 37TH PL SUITE 201
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City | VERO BEACH
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State | FL
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Zip | 32960-4806
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Country | US
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Telephone | 772-492-7051
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Fax |
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Authorized Official
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Title or Position | MBR
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Name | STUART J SHAFER
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Credential | M.D.
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Telephone | 772-492-7051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME72269
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License Number State | FL
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