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General NPI Number Information
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NPI Number | 1730438771
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Entity Type | Organization
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Legal Business Name | NEUROLOGICAL GROUP OF SOUTH FLORIDA INC.
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Dates
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Enumeration Date | 09/06/2012
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 7700 CONGRESS AVE SUITE 1115
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City | BOCA RATON
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State | FL
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Zip | 33487-1352
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Country | US
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Telephone | 561-994-3393
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Fax | 561-994-3395
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Provider Business Mailing Address
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Address Line | 7700 CONGRESS AVE SUITE 1115
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City | BOCA RATON
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State | FL
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Zip | 33487-1352
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Country | US
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Telephone | 561-994-3393
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Fax | 561-994-3395
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Authorized Official
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Title or Position | OWNER
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Name | MR. LOREN HENNICK
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Credential |
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Telephone | 561-994-3393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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