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General NPI Number Information
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NPI Number | 1932059284
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Entity Type | Organization
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Legal Business Name | NEUROBRIGHT DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 1260 CRANE TALON WAY
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City | SANFORD
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State | FL
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Zip | 32771-3978
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Country | US
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Telephone | 689-307-9338
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Fax |
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Provider Business Mailing Address
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Address Line | 1260 CRANE TALON WAY
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City | SANFORD
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State | FL
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Zip | 32771-3978
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Country | US
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Telephone | 689-307-9338
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VICTOR ISANOA
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Credential | ISANOA
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Telephone | 909-278-0086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2472E0500X
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Taxonomy Name | EEG Technician
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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