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General NPI Number Information
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NPI Number | 1841724861
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Entity Type | Organization
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Legal Business Name | NEURO AND EPILEPSY CARE INC
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Dates
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Enumeration Date | 04/17/2017
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Last Update Date | 11/28/2017
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Provider Practice Location Address
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Address Line | 331 N MAITLAND AVE STE D3
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City | MAITLAND
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State | FL
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Zip | 32751-4755
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Country | US
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Telephone | 407-775-5035
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Fax |
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Provider Business Mailing Address
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Address Line | 331 N MAITLAND AVE STE D3
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City | MAITLAND
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State | FL
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Zip | 32751-4755
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Country | US
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Telephone | 407-775-5035
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Fax | 407-255-8823
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Authorized Official
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Title or Position | PRESIDENT/PROVIDER
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Name | HERBERT EZUGHA
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Credential |
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Telephone | 407-775-5035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | ME127563
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License Number State | FL
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