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General NPI Number Information
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NPI Number | 1790924835
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Entity Type | Organization
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Legal Business Name | ADVANCED NEUROLOGY OF THE PALM BEACHES, P.A.
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Dates
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Enumeration Date | 02/12/2009
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 3400 BURNS RD STE 101
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4352
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Country | US
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Telephone | 561-626-1159
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Fax | 561-275-7050
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Provider Business Mailing Address
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Address Line | 3375 BURNS RD SUITE 203
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4349
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Country | US
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Telephone | 561-626-1159
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Fax | 561-626-5788
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | MR. JOSE M HERNANDEZ JR.
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Credential |
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Telephone | 561-626-1159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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