MEDICARE: NEURON PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician

General Provider Information

NPI Number	:	1114734209
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEURON PLLC

Provider Business Mailing Address
First Line	:	2601 UNIVERSITY BLVD W
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2112
Country	:	US
Telephone Number	:	904-274-6040
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 UNIVERSITY BLVD W
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2112
Country	:	US
Telephone Number	:	904-274-6040
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	RUBINA BAKERYWALA
Credential	:	MD
Telephone Number	:	904-274-6040

Provider Enumeration Date	:	12/12/2024
Last Update Date	:	01/29/2025

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Directions to “NEURON PLLC ” Practice Location

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