MEDICARE: NEUROLOGY AND WELLNESS CENTER, INC

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	2084N0400X	Neurology Physician	ME92170	FL

General Provider Information

NPI Number	:	1801147574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROLOGY AND WELLNESS CENTER, INC

Provider Business Mailing Address
First Line	:	882 NW 66TH AVE
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33317-1236
Country	:	US
Telephone Number	:	305-388-1118
Fax Number	:	305-223-3242

Provider Business Practice Location Address
First Line	:	2433 SW 147TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-4082
Country	:	US
Telephone Number	:	305-338-1118
Fax Number	:	305-223-3242

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SONIA TOLGYESI
Credential	:	M.D
Telephone Number	:	305-388-1118

Provider Enumeration Date	:	09/21/2012
Last Update Date	:	09/21/2012

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