| Tavernier Neurological Center, Inc. | |
|
91550 Overseas Hwy Medical Arts Building Suite 115 Tavernier FL 33070-2506 | |
| (305) 853-0415 | |
| (305) 853-1708 |
| Full Name | Tavernier Neurological Center, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 91550 Overseas Hwy, Tavernier, Florida |
| Authorized Official Name and Position | Ricardo Soltero (SECRETARY - TREASURER) |
| Authorized Official Contact | 3058530415 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tavernier Neurological Center, Inc. Po Box 460 Tavernier FL 33070-0460 Ph: (305) 853-0415 | Tavernier Neurological Center, Inc. 91550 Overseas Hwy Medical Arts Building Suite 115 Tavernier FL 33070-2506 Ph: (305) 853-0415 |
| NPI Number | 1811055536 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 12/16/2013 |
| Medicare PECOS PAC ID | 9537159900 |
|---|---|
| Medicare Enrollment ID | O20040517000927 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811055536 | NPI | - | NPPES |
| 263830400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | ME 84115 (Florida) | Primary |
| Provider Name | Elisa M Brown-soltero |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033277728 PECOS PAC ID: 9931199312 Enrollment ID: I20101122000118 |
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