Neurology Center of Florida LLC

Key facts

NPI

1992088009

Entity type

Organization (NPI type 2)

Primary specialty

Specialist 174400000X

Legal business name

NEUROLOGY CENTER OF FLORIDA LLC

Practice address

2808 Enterprise Rd
Suite 104
Debary, FL 32713-2753

Phone

(386) 624-6900

Fax

(386) 624-6993

NPI assigned

Sep 25, 2011

Organization subpart

No

Authorized official

Name

Dr. Deepak Tikku, M.D. NPI 1689748345

Title

President/Owner

Phone

(386) 624-6900

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

Practitioners 1

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

• Deepak Tikku, M.D. Neurology Physician · Debary, FL · NPI 1689748345
  Medicare reassignment NPD Authorized official FL · SPECIALIST

Medicare participation

Medicare fee-for-service enrollment

Enrolled in FL

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 24, 2014.

{
    "created_epoch": "1316908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1992088009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 ENTERPRISE RD",
            "address_2": "SUITE 104",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132753",
            "telephone_number": "386-624-6900",
            "fax_number": "386-624-6993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 ENTERPRISE RD",
            "address_2": "SUITE 104",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132753",
            "telephone_number": "386-624-6900",
            "fax_number": "386-624-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY CENTER OF FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-25",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "TIKKU",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "386-624-6900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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