1487407037 NPI number — ORLANDO NEUROLOGY LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487407037 NPI number — ORLANDO NEUROLOGY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORLANDO NEUROLOGY LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487407037
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1226 LAKE WHITNEY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINDERMERE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34786-6070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-970-3069
Provider Business Mailing Address Fax Number:
407-258-8279

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ADVENT HEALTH ORLANDO HOSPITAL
Provider Second Line Business Practice Location Address:
601 E ROLLINS ST
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-303-5600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/11/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TOSHNIWAL
Authorized Official First Name:
LATA
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
407-970-3069

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)