Neurology Center of Excellence, PLLC

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

Legal business name

NEUROLOGY CENTER OF EXCELLENCE, PLLC

Practice address

837 S Main St
Wildwood, FL 34785-5302

Phone

(352) 750-6387

Fax

(352) 753-7141

NPI assigned

Apr 5, 2011

Organization subpart

No

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

Authorized official

Name

Jonathan Carrier

Title

Billing Manager

Phone

(352) 750-6387

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566864000000",
    "number": "1679862130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 S MAIN ST",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347855302",
            "telephone_number": "352-750-6387",
            "fax_number": "352-753-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 S MAIN ST",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347855302",
            "telephone_number": "352-750-6387",
            "fax_number": "352-753-7141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "804 Highway 466",
            "address_purpose": "LOCATION",
            "city": "Lady Lake",
            "state": "FL",
            "postal_code": "321593918",
            "country_code": "US",
            "telephone_number": "352-750-6387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEUROLOGY CENTER OF EXCELLENCE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2019-08-27",
        "status": "A",
        "authorized_official_last_name": "CARRIER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "352-750-6387"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Wildwood, 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 27, 2019; 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.