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General NPI Number Information
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NPI Number | 1487977237
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Entity Type | Organization
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Legal Business Name | CLERMONT NEUROLOGIC AND CHIROPRACTIC,LLC
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 17307 PAGONIA DRIVE BUILDING #A
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City | CLERMONT
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State | FL
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Zip | 34711-2778
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Country | US
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Telephone | 352-484-0403
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Fax |
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Provider Business Mailing Address
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Address Line | 17307 PAGONIA DRIVE BUILDING #A
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City | CLERMONT
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State | FL
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Zip | 34711-2778
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Country | US
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Telephone | 352-484-0403
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAJPAUL SINGH
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Credential | M.D
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Telephone | 352-484-0403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH7683
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | ME103728
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License Number State | FL
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