Basic Information
| Provider Information | |||||||||
| NPI: | 1568753374 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MIAMI NEUROLOGICAL INSTITUTE, LLC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 402458 | ||||||||
| Address2: | |||||||||
| City: | MIAMI BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331400458 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7866232000 | ||||||||
| FaxNumber: | 7863640532 | ||||||||
| Practice Location | |||||||||
| Address1: | 21097 NE 27TH CT | ||||||||
| Address2: | SUITE 540 | ||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331801204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7866232000 | ||||||||
| FaxNumber: | 7863640532 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2011 | ||||||||
| LastUpdateDate: | 10/23/2012 | ||||||||
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| AuthorizedOfficialLastName: | FIGUEREO | ||||||||
| AuthorizedOfficialFirstName: | SANTIAGO | ||||||||
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| AuthorizedOfficialTitleorPosition: | NEUROSURGEON/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7866232000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207T00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.