Organization Active NPI

Florida Neurology Institute

  • Neurology Physician
  • Lakeland, FL
National Provider Identifier
1962444372
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME86321 Issued in FL
Legal business name
FLORIDA NEUROLOGY INSTITUTE
Practice address
1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone
(352) 254-0053
Fax
(352) 324-2929
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Authorized official

Name
Mrs. Marisol GonzalezNPI 1952248577
Title
Office Manager
Phone
(352) 254-0233

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X ME86321 FL Primary

Addresses

Primary practice location

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543

Mailing address

PO Box 493235
Leesburg, FL 34749-3235
Phone (352) 254-0233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050114000775 FL Part B Supplier - Clinic/Group Practice 0941259022 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Locations

3140 NW Medical Center Ln
Ste 100
Lake City, FL 32055
Phone (386) 752-4004

11602 Lake Underhill Rd
Ste 116
Orlando, FL 32825
Phone (352) 254-0233

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FAHDAD

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1962444372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 493235",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347493235",
            "telephone_number": "352-254-0233",
            "fax_number": "352-324-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054543",
            "telephone_number": "352-254-0053",
            "fax_number": "352-324-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA NEUROLOGY INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "MARISOL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "352-254-0233",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME86321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.