Neurologic Associates of Central Brevard Inc

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

NEUROLOGIC ASSOCIATES OF CENTRAL BREVARD INC

Practice address

1395 N Courtenay Pkwy
Suite #106
Merritt Island, FL 32953-4400

Phone

(321) 452-1224

Fax

(321) 453-7784

NPI assigned

Jun 1, 2007

Organization subpart

No

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

Authorized official

Name

Patricia Valluzzi

Title

Office Manager

Phone

(321) 452-1224

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Roberto Mixco, MD

  • Neurology Physician
  • Merritt Island, FL
  • NPI 1396805255
  Medicare reassignment NPD
• Lori K Bourne, P.A.

  • Medical Physician Assistant
  • Merritt Island, FL
  • NPI 1841449766
  Medicare reassignment

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1295937373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 N COURTENAY PKWY",
            "address_2": "SUITE #106",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534400",
            "telephone_number": "321-452-1224",
            "fax_number": "321-453-7784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 N COURTENAY PKWY",
            "address_2": "SUITE #106",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534400",
            "telephone_number": "321-452-1224",
            "fax_number": "321-453-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGIC ASSOCIATES OF CENTRAL BREVARD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "VALLUZZI",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "321-452-1224"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053783700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "77741",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherry Necessary-Corrigan, ARNP
• David Clayton Neely, M.D.
• Dena Marie Nelson, CASE MANAGER
• Margetta Nelson, LPN
• Neuro Imaging Institute II Inc
• Neuroskeletal Imaging LLC
• New Life Speech Therapy
• New Life Speech Therapy
• Lynn Nguyen
• Thaiduc Nguyen, DO

• Neurology Physician in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.