Southeast Diagnostic Consultants, LLC

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

Legal business name

SOUTHEAST DIAGNOSTIC CONSULTANTS, LLC

Doing business as

Southeast Neurology, LLC

Practice address

2000 S Bayshore Dr Apt 56
Miami, FL 33133-3252

Phone

(210) 598-4277

NPI assigned

Dec 27, 2022

Organization subpart

No

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

Authorized official

Name

Roxanna Laroque

Title

Director, Client Experience

Phone

(210) 598-4277

Specialties & licenses 4

Addresses

Other names 1

• Southeast Neurology, LLC Doing business as

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672099200000",
    "number": "1083327886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 N LOOP 1604 E # 105-612",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321339",
            "telephone_number": "210-598-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S BAYSHORE DR APT 56",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331333252",
            "telephone_number": "210-598-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST DIAGNOSTIC CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "LAROQUE",
        "authorized_official_first_name": "ROXANNA",
        "authorized_official_title_or_position": "DIRECTOR, CLIENT EXPERIENCE",
        "authorized_official_telephone_number": "210-598-4277"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Neurology, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South V Transport
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• Michelle Southby
• Southdade Health Services
• Southdade Wellness, Inc
• Southeast Medical Lab Inc
• Southeast Medical Supplies Center Inc
• Southeast Physician Associates 1, LLC.
• Southeast Physician Associates Inc
• Southeast Urgent Care Group, Inc.

• Clinical Neurophysiology Physician in Miami, FL
• Providers in Miami, FL by specialty
• Clinical Neurophysiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.