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General NPI Number Information
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NPI Number | 1902664576
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Entity Type | Organization
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Legal Business Name | JUNCOS NEURO CONSULTING, LLC
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Dates
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Enumeration Date | 03/08/2024
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 1100 NORTHSIDE FORSYTH DR STE 210
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City | CUMMING
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State | GA
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Zip | 30041-6016
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Country | US
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Telephone | 470-239-3602
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Fax | 404-698-3463
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Provider Business Mailing Address
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Address Line | 1100 NORTHSIDE FORSYTH DR STE 210
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City | CUMMING
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State | GA
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Zip | 30041-6016
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Country | US
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Telephone | 470-239-3602
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Fax | 404-698-3463
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. JORGE LUIS JUNCOS
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Credential |
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Telephone | 470-239-3602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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