Provider Demographics
NPI:1225889553
Name:COMPLETE NEUROLOGICAL CARE OF MIAMI PA
Entity type:Organization
Organization Name:COMPLETE NEUROLOGICAL CARE OF MIAMI PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTROVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-634-9425
Mailing Address - Street 1:7730 BOYNTON BEACH BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-6155
Mailing Address - Country:US
Mailing Address - Phone:347-634-9425
Mailing Address - Fax:
Practice Address - Street 1:200 W CYPRESS CREEK RD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-2174
Practice Address - Country:US
Practice Address - Phone:347-634-9425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty