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General NPI Number Information
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NPI Number | 1710936620
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Entity Type | Organization
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Legal Business Name | NEURO ORTHO GROUP
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 150 S ANDREWS AVE SUITE # 350
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3298
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Country | US
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Telephone | 954-545-3433
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Fax | 954-545-4012
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Provider Business Mailing Address
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Address Line | 150 S ANDREWS AVE SUITE # 350
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3298
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Country | US
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Telephone | 954-545-3433
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Fax | 954-545-4012
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Authorized Official
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Title or Position | ORTHOPEDIC SURGEON
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Name | DR. AMY MARIE STARRY
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Credential | D.O.
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Telephone | 954-545-3433
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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 | OS8384
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License Number State | FL
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