Organization Active NPI

Neuron PLLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Jacksonville, FL
National Provider Identifier
1114734209
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
Legal business name
NEURON PLLC
Practice address
2601 University Blvd W
Jacksonville, FL 32217-2112
Phone
(904) 274-6040
NPI assigned
Dec 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Authorized official

Name
Rubina Bakerywala, MDNPI 1861682940
Title
MD
Phone
(904) 274-6040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0402X Primary

Addresses

Primary practice location

2601 University Blvd W
Jacksonville, FL 32217-2112

Mailing address

2601 University Blvd W
Jacksonville, FL 32217-2112
Phone (904) 274-6040

National Provider Directory

National Provider Directory

Locations

2604 University Blvd W
Jacksonville, FL 32217

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1114734209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 UNIVERSITY BLVD W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172112",
            "telephone_number": "904-274-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 UNIVERSITY BLVD W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172112",
            "telephone_number": "904-274-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-12",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "BAKERYWALA",
        "authorized_official_first_name": "RUBINA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "904-274-6040",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.