| The Neurodiagnostic Center Of Central Florida Pa | |
|
40124 Highway 27 Ste 204 Davenport FL 33837-5905 | |
| (863) 421-4700 | |
| (863) 421-4715 |
| Full Name | The Neurodiagnostic Center Of Central Florida Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 40124 Highway 27, Davenport, Florida |
| Authorized Official Name and Position | Shahid Riaz (OWNER) |
| Authorized Official Contact | 8634214700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Neurodiagnostic Center Of Central Florida Pa 40124 Highway 27 Ste 204 Davenport FL 33837-5905 Ph: (863) 421-4700 | The Neurodiagnostic Center Of Central Florida Pa 40124 Highway 27 Ste 204 Davenport FL 33837-5905 Ph: (863) 421-4700 |
| NPI Number | 1386830198 |
|---|---|
| Provider Enumeration Date | 09/15/2007 |
| Last Update Date | 08/11/2011 |
| Medicare PECOS PAC ID | 7911963434 |
|---|---|
| Medicare Enrollment ID | O20041207000488 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386830198 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | ME75134 (Florida) | Primary |
| Provider Name | Shahid Riaz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1891771119 PECOS PAC ID: 5991761413 Enrollment ID: I20120118000026 |
| Provider Name | Jannette E Troche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326508292 PECOS PAC ID: 1254744923 Enrollment ID: I20210120000260 |
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