Organization Active NPI

Tavernier Neurological Center, Inc.

  • Neurology Physician
  • Tavernier, FL
National Provider Identifier
1811055536
Registry record updated Dec 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME 84115 Issued in FL
Legal business name
TAVERNIER NEUROLOGICAL CENTER, INC.
Practice address
91550 Overseas Hwy
Medical Arts Building Suite 115
Tavernier, FL 33070-2506
Phone
(305) 853-0415
Fax
(305) 853-1708
NPI assigned
Dec 5, 2006
Last updated
Dec 16, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2013

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

Authorized official

Name
Mr. Ricardo Soltero
Title
Secretary - Treasurer
Phone
(305) 853-0415

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X ME 84115 FL Primary

Addresses

Primary practice location

91550 Overseas Hwy
Medical Arts Building Suite 115
Tavernier, FL 33070-2506

Mailing address

PO Box 460
Tavernier, FL 33070-0460
Phone (305) 853-0415

Other identifiers 1

IdentifierTypeStateIssuer
263830400MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387152000000",
    "number": "1811055536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 460",
            "city": "TAVERNIER",
            "state": "FL",
            "postal_code": "330700460",
            "telephone_number": "305-853-0415",
            "fax_number": "305-853-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91550 OVERSEAS HWY",
            "address_2": "MEDICAL ARTS BUILDING SUITE 115",
            "city": "TAVERNIER",
            "state": "FL",
            "postal_code": "330702506",
            "telephone_number": "305-853-0415",
            "fax_number": "305-853-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAVERNIER NEUROLOGICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2013-12-16",
        "status": "A",
        "authorized_official_last_name": "SOLTERO",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_title_or_position": "SECRETARY - TREASURER",
        "authorized_official_telephone_number": "305-853-0415",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME 84115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263830400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavernier, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; 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.