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NPI Code Detail

MEDICARE: NEUROINTERVENTIONAL CONSULTANTS, PA

MEDICARE: NEUROINTERVENTIONAL CONSULTANTS, PA
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
12085N0700XNeuroradiology PhysicianME114714FL
2207T00000XNeurological Surgery PhysicianME114714FL

General Provider Information

NPI Number : 1609291368
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEUROINTERVENTIONAL CONSULTANTS, PA
Provider Business Mailing Address
First Line : 100 LINCOLN RD
Second Line : # 1403
City : MIAMI BEACH
State : FL
Zip : 33139-2013
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 LINCOLN RD
Second Line : # 1403
City : MIAMI BEACH
State : FL
Zip : 33139-2013
Country : US
Telephone Number : 210-287-7311
Fax Number :
Authorized Official
Title or Position : DIRECTOR / PRESIDENT
Name : PATRICIA M FERNANDEZ
Credential : MD
Telephone Number : 210-287-7311
Provider Enumeration Date : 03/04/2014
Last Update Date : 04/30/2014

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Directions to “NEUROINTERVENTIONAL CONSULTANTS, PA ” Practice Location

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