1235591009 NPI number — ACADEMY OF NEUROSURGICAL PHYSICIANS, INC.

Table of content: (NPI 1235591009)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235591009 NPI number — ACADEMY OF NEUROSURGICAL PHYSICIANS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACADEMY OF NEUROSURGICAL PHYSICIANS, INC.
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:
1235591009
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1685 S STATE ROAD 7 STE 4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLLYWOOD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33023-6721
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-459-6000
Provider Business Mailing Address Fax Number:
954-459-3333

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1685 S STATE ROAD 7 STE 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLLYWOOD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33023-6721
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-459-6000
Provider Business Practice Location Address Fax Number:
954-459-3333
Provider Enumeration Date:
03/22/2016

Additional Information

Authorized Official

Authorized Official Last Name:
HALL
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
954-459-4600

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 264899700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 140007991 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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