The Neurodiagnostic Center of Central Florida PA

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

License

ME75134 Issued in FL

Legal business name

THE NEURODIAGNOSTIC CENTER OF CENTRAL FLORIDA PA

Practice address

40124 Highway 27
Ste 204
Davenport, FL 33837-5905

Phone

(863) 421-4700

Fax

(863) 421-4715

NPI assigned

Sep 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Shahid Riaz, MDNPI 1891771119

Title

Owner

Phone

(863) 421-4700

Specialties & licenses 1

Addresses

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.

• Shahid Riaz, MD

  • Neurology Physician
  • Davenport, FL
  • NPI 1891771119
  Medicare reassignment NPD Authorized official
• Jannette E Troche, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Oviedo, FL
  • NPI 1326508292
  Medicare reassignment NPD

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

{
    "created_epoch": "1189814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313020800000",
    "number": "1386830198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40124 HIGHWAY 27",
            "address_2": "STE 204",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375905",
            "telephone_number": "863-421-4700",
            "fax_number": "863-421-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40124 HIGHWAY 27",
            "address_2": "STE 204",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375905",
            "telephone_number": "863-421-4700",
            "fax_number": "863-421-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE NEURODIAGNOSTIC CENTER OF CENTRAL FLORIDA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-15",
        "last_updated": "2011-08-11",
        "status": "A",
        "authorized_official_last_name": "RIAZ",
        "authorized_official_first_name": "SHAHID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-421-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "FL",
            "license": "ME75134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Michael Teffeau, D.O.
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• Pankti Thaker, CRNA
• The Magic Hands Art LLC
• The Nurtured Mind, Inc.
• Therapeutic Expressions Rehabilitation Services
• Therapeutic Solutions Home Health 2010
• Therapy by Olivo
• Brandon Thomas

• Clinical Neurophysiology Physician in Davenport, FL
• Providers in Davenport, 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 Aug 11, 2011; 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.