| Neurology & Spine Disorders Llc | |
|
5111 S Ridgewood Ave Suite 102 Port Orange FL 32127-5169 | |
| (386) 763-4484 | |
| (386) 763-1288 |
| Full Name | Neurology & Spine Disorders Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 5111 S Ridgewood Ave, Port Orange, Florida |
| Authorized Official Name and Position | Al Falco (CEO) |
| Authorized Official Contact | 3862747118 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology & Spine Disorders Llc 1673 Mason Ave Suite 107 Daytona Beach FL 32117-5515 Ph: (386) 274-7118 | Neurology & Spine Disorders Llc 5111 S Ridgewood Ave Suite 102 Port Orange FL 32127-5169 Ph: (386) 763-4484 |
| NPI Number | 1790008811 |
|---|---|
| Provider Enumeration Date | 03/03/2010 |
| Last Update Date | 09/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790008811 | NPI | - | NPPES |
| 000EZ | Other | FL | BLUE CROSS BLUE SHIELD |
| DQ2689 | Other | FL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | ME46005 (Florida) | Primary |
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