| Neurology Restoration | |
|
1701 Se Hillmoor Dr Suite D-16 Port Saint Lucie FL 34952-7552 | |
| (772) 201-1162 | |
| Not Available |
| Full Name | Neurology Restoration |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1701 Se Hillmoor Dr, Port Saint Lucie, Florida |
| Authorized Official Name and Position | Luz G Vazquez (OWNER/MD) |
| Authorized Official Contact | 7722101162 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology Restoration Po Box 7938 Port Saint Lucie FL 34985-7938 Ph: (772) 210-1162 | Neurology Restoration 1701 Se Hillmoor Dr Suite D-16 Port Saint Lucie FL 34952-7552 Ph: (772) 201-1162 |
| NPI Number | 1043765753 |
|---|---|
| Provider Enumeration Date | 08/23/2016 |
| Last Update Date | 10/02/2017 |
| Medicare PECOS PAC ID | 6507133741 |
|---|---|
| Medicare Enrollment ID | O20170518002424 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043765753 | NPI | - | NPPES |
| 257198600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | ME68140 (Florida) | Primary |
| Provider Name | Luz G Vazquez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568418325 PECOS PAC ID: 6507936945 Enrollment ID: I20080528000493 |
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