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General NPI Number Information
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NPI Number | 1295019990
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Entity Type | Organization
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Legal Business Name | NORTH CENTRAL FLORIDA NEURODIAGNOSTIC SERVICES, LLC
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Dates
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Enumeration Date | 09/30/2011
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 12076 TECHNOLOGY AVE
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City | ALACHUA
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State | FL
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Zip | 32615
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Country | US
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Telephone | 352-375-5553
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Fax | 352-505-5506
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Provider Business Mailing Address
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Address Line | PO BOX 2459
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City | ALACHUA
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State | FL
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Zip | 32616-2459
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Country | US
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Telephone | 352-375-5553
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Fax | 888-972-4494
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MR. ADRIAN F HARPER SR.
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Credential |
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Telephone | 352-375-5553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 800026857
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License Number State | FL
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