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General NPI Number Information
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NPI Number | 1568694925
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Entity Type | Organization
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Legal Business Name | FLORIDA NEUROLOGY CENTER OF ORLANDO,P.A
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Dates
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Enumeration Date | 08/19/2009
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Last Update Date | 10/05/2014
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Provider Practice Location Address
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Address Line | 9301 RAVEN DELL ST
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City | ORLANDO
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State | FL
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Zip | 32825-8088
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Country | US
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Telephone | 407-382-6292
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Fax |
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Provider Business Mailing Address
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Address Line | 9301 RAVEN DELL ST
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City | ORLANDO
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State | FL
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Zip | 32825-8088
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Country | US
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Telephone | 407-382-6292
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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. HENRY J COMITER
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Credential | M.D
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Telephone | 407-382-6292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MEOO19625
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License Number State | FL
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