Maybach Neurosurgery Clinic LLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

MAYBACH NEUROSURGERY CLINIC LLC

Practice address

1545 Hand Ave Ste A1
Ormond Beach, FL 32174-1140

Phone

(386) 457-7117

NPI assigned

Jan 26, 2023

Organization subpart

No

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

Authorized official

Name

Adam Lewis

Title

Owner

Phone

(386) 457-7117

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1629784376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 HAND AVE STE A1",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321741140",
            "telephone_number": "386-457-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 HAND AVE STE A1",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321741140",
            "telephone_number": "386-457-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYBACH NEUROSURGERY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-457-7117"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.