Provider Demographics
NPI:1194272526
Name:NEURO HEALTHCARE LLC
Entity type:Organization
Organization Name:NEURO HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BORTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:321-586-2240
Mailing Address - Street 1:3260 MURRELL RD
Mailing Address - Street 2:SUITE 101-B
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4569
Mailing Address - Country:US
Mailing Address - Phone:321-586-2240
Mailing Address - Fax:321-586-2230
Practice Address - Street 1:3260 MURRELL RD
Practice Address - Street 2:SUITE 101-B
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-4569
Practice Address - Country:US
Practice Address - Phone:321-586-2240
Practice Address - Fax:321-586-2230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9398111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty