1235807611 NPI number — NEUROSCIENCE CONSULTANTS LLP

Table of content: (NPI 1235807611)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235807611 NPI number — NEUROSCIENCE CONSULTANTS LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEUROSCIENCE CONSULTANTS LLP
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:
1235807611
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 160010
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIALEAH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33016-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-924-1311
Provider Business Mailing Address Fax Number:
786-924-1313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8950 SW 152ND ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALMETTO BAY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33157-1901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-279-2226
Provider Business Practice Location Address Fax Number:
786-364-6862
Provider Enumeration Date:
09/01/2021

Additional Information

Authorized Official

Authorized Official Last Name:
PAULEY
Authorized Official First Name:
LANNY
Authorized Official Middle Name:
E
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
786-924-1311

Provider Taxonomy Codes

  • Taxonomy code: 2084N0402X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084S0012X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 102142201 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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