Neurophysiology Diagnostic Center LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

NEUROPHYSIOLOGY DIAGNOSTIC CENTER LLC

Practice address

4102 N Macdill Ave Unit B
Tampa, FL 33607-6717

Phone

(813) 871-2853

Fax

(813) 877-1609

NPI assigned

Sep 6, 2019

Last updated

Sep 9, 2019By 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. Rafael Miguel Rodriguez, MD

Title

Manager/Owner

Phone

(813) 871-2853

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Camp, ARNP

  • Primary Care Nurse Practitioner
  • Tampa, FL
  • NPI 1366761546
  NPD (past)

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567987200000",
    "number": "1720637317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 N MACDILL AVE UNIT B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076717",
            "telephone_number": "813-871-2853",
            "fax_number": "813-877-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 N MACDILL AVE UNIT B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076717",
            "telephone_number": "813-871-2853",
            "fax_number": "813-877-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROPHYSIOLOGY DIAGNOSTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-09",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_middle_name": "MIGUEL",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "813-871-2853",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "293D00000X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurovascular Home Healthcare, LLC

• Physiological Laboratory in Tampa, FL
• Providers in Tampa, FL by specialty
• Physiological Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.