Organization Active NPI

Neuroedge Medical LLC

  • Electroneurodiagnostic Specialist/Technologist
  • Winter Park, FL
National Provider Identifier
1083169122
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X
Legal business name
NEUROEDGE MEDICAL LLC
Practice address
127 W Fairbanks Ave # 180
Winter Park, FL 32789
Phone
(877) 479-4004
Fax
(407) 440-1820
NPI assigned
Aug 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carlos RamosNPI 1619396744
Title
Manager
Phone
(877) 479-4004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246ZE0600X FL Primary

Addresses

Primary practice location

127 W Fairbanks Ave # 180
Winter Park, FL 32789

Mailing address

127 W Fairbanks Ave # 180
Winter Park, FL 32789-4326
Phone (877) 479-4004

National Provider Directory

National Provider Directory

Locations

127 W Fairbanks Ave
Winter Park, FL 32789
Phone (407) 906-5092

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548028800000",
    "number": "1083169122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W FAIRBANKS AVE # 180",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894326",
            "telephone_number": "877-479-4004",
            "fax_number": "407-440-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 W FAIRBANKS AVE # 180",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32789",
            "telephone_number": "877-479-4004",
            "fax_number": "407-440-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROEDGE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-18",
        "last_updated": "2019-01-21",
        "status": "A",
        "authorized_official_last_name": "RAMOS",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "877-479-4004"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.