Active NPI
Leila Patallo
- Neurology Physician
- Titusville, FL
National Provider Identifier
1609063296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- ME84982
- Legal business name
- LEILA PATALLO
- Practice address
- 1781 Garden St
Titusville, FL 32796-3221 - Phone
- (321) 383-0900
- Fax
- (321) 383-0024
- NPI assigned
- Sep 27, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Miss Delphine Celine Jacquet
- Title
- Office Manager
- Phone
- (321) 383-0900
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | ME84982 | FL | Primary |
Addresses
Primary practice location
1781 Garden St
Titusville, FL 32796-3221
Mailing address
1781 Garden St
Titusville, FL 32796-3221
Phone (321) 383-0900
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3956438 | Other | FL | AETNA GROUP NUMBER |
| DD8925 | Other | FL | PALMETTO GBA GROUP NUMBER |
| 7735972 | Other | FL | CIGNA |
| 13868 | Other | FL | BLUE CROSS BLUE SHIELD |
| 7835391 | Other | FL | AETNA |
Other names 1
- Titusville Neurology
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190851200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1213747200000",
"number": "1609063296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1781 GARDEN ST",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327963221",
"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": "1781 GARDEN ST",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327963221",
"telephone_number": "321-383-0900",
"fax_number": "321-383-0024"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEILA PATALLO",
"organizational_subpart": "NO",
"enumeration_date": "2007-09-27",
"last_updated": "2008-06-18",
"status": "A",
"authorized_official_last_name": "JACQUET",
"authorized_official_first_name": "DELPHINE",
"authorized_official_middle_name": "CELINE",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "321-383-0900",
"authorized_official_name_prefix": "Miss"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neurology",
"state": "FL",
"license": "ME84982",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA GROUP NUMBER",
"identifier": "3956438",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO GBA GROUP NUMBER",
"identifier": "DD8925",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "7735972",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "13868",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7835391",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Titusville Neurology",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Titusville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.