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General NPI Number Information
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NPI Number | 1710774641
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Entity Type | Organization
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Legal Business Name | NEUROSPA LLC
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 2306 ASHLEY OAKS CIR STE 101
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6435
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Country | US
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Telephone | 727-808-9907
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Fax |
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Provider Business Mailing Address
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Address Line | 2306 ASHLEY OAKS CIR STE 101
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6435
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Country | US
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Telephone | 727-808-9907
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MONICA BERND
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Credential |
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Telephone | 727-808-9907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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