Provider Demographics
NPI:1063787539
Name:SOUTH FLORIDA NEUROPATHY CENTER INC
Entity type:Organization
Organization Name:SOUTH FLORIDA NEUROPATHY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FAULHABER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:772-873-5552
Mailing Address - Street 1:3233 SW PORT ST LUCIE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-3490
Mailing Address - Country:US
Mailing Address - Phone:772-873-5552
Mailing Address - Fax:772-873-5747
Practice Address - Street 1:3233 SW PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-3490
Practice Address - Country:US
Practice Address - Phone:772-873-5552
Practice Address - Fax:772-873-5747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-17
Last Update Date:2012-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Multi-Specialty