Neurology & Neurodiagnostics Llc | |
1355 S International Pkwy Suite 2451 Lake Mary FL 32746-1694 | |
(407) 250-3290 | |
Not Available |
Full Name | Neurology & Neurodiagnostics Llc |
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Speciality | Psychiatry & Neurology |
Location | 1355 S International Pkwy, Lake Mary, Florida |
Authorized Official Name and Position | Juan Ros-escalante (PHYSICIAN) |
Authorized Official Contact | 6027435501 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Neurology & Neurodiagnostics Llc Po Box 951316 Lake Mary FL 32795-1316 Ph: () - | Neurology & Neurodiagnostics Llc 1355 S International Pkwy Suite 2451 Lake Mary FL 32746-1694 Ph: (407) 250-3290 |
NPI Number | 1760882617 |
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Provider Enumeration Date | 08/28/2014 |
Last Update Date | 11/18/2016 |
Medicare PECOS PAC ID | 6103047295 |
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Medicare Enrollment ID | O20141014001014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760882617 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | ME109269 (Florida) | Primary |
Provider Name | Juan Ros Escalante |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1104909647 PECOS PAC ID: 4587836242 Enrollment ID: I20111003000158 |
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