Provider Demographics
NPI:1306911375
Name:NORTH FLORIDA NEUROSURGERY
Entity type:Organization
Organization Name:NORTH FLORIDA NEUROSURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIANS ASST
Authorized Official - Prefix:MS
Authorized Official - First Name:SEE WAI
Authorized Official - Middle Name:ELSIE
Authorized Official - Last Name:LO
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:352-331-0811
Mailing Address - Street 1:6510 NW 9TH BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4245
Mailing Address - Country:US
Mailing Address - Phone:352-331-0811
Mailing Address - Fax:352-332-6387
Practice Address - Street 1:6510 NW 9TH BLVD STE 1
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4245
Practice Address - Country:US
Practice Address - Phone:352-331-0811
Practice Address - Fax:352-332-6387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103775363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty