| Neuro-stat | |
|
501 S Lincoln Ave Ste 22 Clearwater FL 33756-5964 | |
| (727) 357-7828 | |
| (727) 337-7646 |
| Full Name | Neuro-stat |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 501 S Lincoln Ave Ste 22, Clearwater, Florida |
| Authorized Official Name and Position | Carl Tyler Shenkman (CEO) |
| Authorized Official Contact | 7273306038 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuro-stat 501 S Lincoln Ave Ste 22 Clearwater FL 33756-5964 Ph: (727) 357-7828 | Neuro-stat 501 S Lincoln Ave Ste 22 Clearwater FL 33756-5964 Ph: (727) 357-7828 |
| NPI Number | 1104365550 |
|---|---|
| Provider Enumeration Date | 02/17/2017 |
| Last Update Date | 01/08/2024 |
| Certification Date | 01/08/2024 |
| Medicare PECOS PAC ID | 6305103698 |
|---|---|
| Medicare Enrollment ID | O20171121002049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104365550 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Carl T Shenkman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083664874 PECOS PAC ID: 8325028749 Enrollment ID: I20140728000815 |
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