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General NPI Number Information
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NPI Number | 1023133097
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Entity Type | Organization
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Legal Business Name | NEUROLOGY ASSOCIATES OF SOUTH FLORIDA LLC
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 03/18/2011
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Provider Practice Location Address
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Address Line | 201 NW 82ND AVE SUITE 502
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City | PLANTATION
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State | FL
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Zip | 33324-7808
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Country | US
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Telephone | 954-236-6602
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Fax | 954-236-8045
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Provider Business Mailing Address
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Address Line | PO BOX 824007
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City | PEMBROKE PINES
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State | FL
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Zip | 33082-4007
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Country | US
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Telephone | 954-236-6602
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Fax | 954-236-8045
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ROY DE BASISH
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Credential |
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Telephone | 954-236-6602
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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 |
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License Number State |
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