Titusville Neurology LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

TITUSVILLE NEUROLOGY LLC

Practice address

123 S Park Ave
Titusville, FL 32796-3377

Phone

(321) 383-0900

Fax

(321) 383-0024

NPI assigned

Dec 16, 2013

Last updated

Jan 27, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Leila Maria Patallo, M.D.

Title

Owner/Physician

Phone

(321) 383-0900

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390780800000",
    "number": "1508287715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 S PARK AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963377",
            "telephone_number": "321-383-0900",
            "fax_number": "321-383-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S PARK AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963377",
            "telephone_number": "321-383-0900",
            "fax_number": "321-383-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TITUSVILLE NEUROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-16",
        "last_updated": "2014-01-27",
        "status": "A",
        "authorized_official_last_name": "PATALLO",
        "authorized_official_first_name": "LEILA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "321-383-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "13868",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Titusville, FL
• Providers in Titusville, 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 27, 2014; 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.