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General NPI Number Information
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NPI Number | 1588140594
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Entity Type | Organization
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Legal Business Name | NEURO INTERGRATION, LLC
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Dates
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Enumeration Date | 07/12/2018
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Last Update Date | 07/12/2018
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Provider Practice Location Address
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Address Line | 441 S STATE ROAD 7 STE 14
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City | MARGATE
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State | FL
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Zip | 33068-1967
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Country | US
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Telephone | 561-504-2305
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Fax |
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Provider Business Mailing Address
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Address Line | 125 NEPTUNE DR
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City | HYPOLUXO
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State | FL
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Zip | 33462-6019
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Country | US
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Telephone | 561-504-2305
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | VERONICA HERMNANDEZ
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Credential |
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Telephone | 954-203-3584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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