Basic Information
| Provider Information | |||||||||
| NPI: | 1639375322 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEUROLOGIC CENTER OF SOUTH FLORIDA INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8940 N KENDALL DR | ||||||||
| Address2: | 802E | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331762148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055954041 | ||||||||
| FaxNumber: | 3055957799 | ||||||||
| Practice Location | |||||||||
| Address1: | 8940 N KENDALL DR | ||||||||
| Address2: | 802E | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331762148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055954041 | ||||||||
| FaxNumber: | 3055957799 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | APTMAN | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3055954041 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 2084N0400X | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.