| Brain And Spine Institute Of Port Orange, Llc | |
|
1211 Dunlawton Ave Port Orange FL 32127-2913 | |
| (386) 304-0111 | |
| Not Available |
| Full Name | Brain And Spine Institute Of Port Orange, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1211 Dunlawton Ave, Port Orange, Florida |
| Authorized Official Name and Position | Timothy Joseph Wierzbicki (CEO) |
| Authorized Official Contact | 3863040111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brain And Spine Institute Of Port Orange, Llc 1211 Dunlawton Ave Port Orange FL 32127-2913 Ph: (386) 304-0111 | Brain And Spine Institute Of Port Orange, Llc 1211 Dunlawton Ave Port Orange FL 32127-2913 Ph: (386) 304-0111 |
| NPI Number | 1699016949 |
|---|---|
| Provider Enumeration Date | 03/12/2013 |
| Last Update Date | 03/15/2013 |
| Medicare PECOS PAC ID | 2264679596 |
|---|---|
| Medicare Enrollment ID | O20130506000241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699016949 | NPI | - | NPPES |
| 259058100 | Medicaid | FL | |
| 130022355 | Other | FL | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | ME80334 (Florida) | Primary |
| Provider Name | Timothy J Wierzbicki |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134145741 PECOS PAC ID: 0143320812 Enrollment ID: I20070710000768 |
Counseling Associates Of Port Orange, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3959 S Nova Rd, Suite 5, Port Orange, FL 32127 Phone: 386-761-2390 Fax: 386-761-3256 | |
Center For Behavioral Medicine Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1730 Dunlawton Ave, Suite 3, Port Orange, FL 32127 Phone: 138-695-7390 | |
Self Quest Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3959 S Nova Rd Ste B-15, Port Orange, FL 32127 Phone: 386-566-6632 Fax: 855-471-0759 | |
Dr Anthony S Capozzi Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1730 Dunlawton Ave Ste 3, Port Orange, FL 32127 Phone: 386-957-3905 | |
Bloom Behavioral Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2473 Karl Dr, Port Orange, FL 32128 Phone: 904-788-9474 Fax: 760-205-4866 | |
Sue Levy Psyd Lcsw Pa Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3959 S Nova Road, Bldg B Suite 23, Port Orange, FL 32127 Phone: 386-253-8439 Fax: 386-253-8439 | |
Grimes Neurology And Concussion Center, P.a. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 800 Dunlawton Ave Ste 103, Port Orange, FL 32127 Phone: 386-679-3270 |