Provider Demographics
NPI:1316929557
Name:NEUROLOGY MOBILE SYSTEM ASSOCIATES INC
Entity type:Organization
Organization Name:NEUROLOGY MOBILE SYSTEM ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALFARO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-270-7771
Mailing Address - Street 1:7374 SW 93RD AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3246
Mailing Address - Country:US
Mailing Address - Phone:305-270-7771
Mailing Address - Fax:305-270-7775
Practice Address - Street 1:7374 SW 93RD AVE STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3246
Practice Address - Country:US
Practice Address - Phone:305-270-7771
Practice Address - Fax:305-270-7775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL999999999174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE1917Medicare ID - Type UnspecifiedMARILYN ALFARO
FLF47194Medicare UPIN