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General NPI Number Information
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NPI Number | 1932627171
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Entity Type | Organization
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Legal Business Name | NEURO CONSULTANTS LLC
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Dates
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Enumeration Date | 09/08/2017
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Last Update Date | 09/08/2017
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Provider Practice Location Address
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Address Line | 3502 KYOTO GARDENS DRIVE SUTIE A
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410
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Country | US
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Telephone | 561-776-8891
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Fax | 866-436-2183
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Provider Business Mailing Address
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Address Line | 9960 NW 116TH WAY STE 13
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City | MEDLEY
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State | FL
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Zip | 33178-1175
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Country | US
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Telephone | 786-924-1311
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Fax | 786-924-1313
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Authorized Official
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Title or Position | PHYSICIAN-SELF
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Name | JENNIFER BUCZYNER
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Credential | MD
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Telephone | 404-542-1412
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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 | ME116845
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License Number State | FL
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