| Vip Neurology | |
|
300 Fortenberry Rd Merritt Island FL 32952-3621 | |
| (321) 325-1155 | |
| (321) 373-0055 |
| Full Name | Vip Neurology |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 300 Fortenberry Rd, Merritt Island, Florida |
| Authorized Official Name and Position | Nikolay Stamboliyski (AUTHORIZED PERSON) |
| Authorized Official Contact | 3217510041 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vip Neurology 6105 N Wickham Rd #411682 Melbourne FL 32941-7001 Ph: () - | Vip Neurology 300 Fortenberry Rd Merritt Island FL 32952-3621 Ph: (321) 325-1155 |
| NPI Number | 1659774685 |
|---|---|
| Provider Enumeration Date | 10/05/2014 |
| Last Update Date | 12/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659774685 | NPI | - | NPPES |
| 261465100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | ME81256 (Florida) | Primary |
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