Provider Demographics
NPI:1427049857
Name:CENTER FOR NEUROLOGICAL DISORDERS PA
Entity type:Organization
Organization Name:CENTER FOR NEUROLOGICAL DISORDERS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ZUBAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-422-2141
Mailing Address - Street 1:13005 SOUTHERN BLVD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-9206
Mailing Address - Country:US
Mailing Address - Phone:561-422-2141
Mailing Address - Fax:561-422-2161
Practice Address - Street 1:13005 SOUTHERN BLVD
Practice Address - Street 2:SUITE 115
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9206
Practice Address - Country:US
Practice Address - Phone:561-422-2141
Practice Address - Fax:561-422-2161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS79692084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8331Medicare PIN