Provider Demographics
NPI:1841724861
Name:NEURO AND EPILEPSY CARE INC
Entity type:Organization
Organization Name:NEURO AND EPILEPSY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:EZUGHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-775-5035
Mailing Address - Street 1:331 N MAITLAND AVE STE D3
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4755
Mailing Address - Country:US
Mailing Address - Phone:407-775-5035
Mailing Address - Fax:407-255-8823
Practice Address - Street 1:331 N MAITLAND AVE STE D3
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4755
Practice Address - Country:US
Practice Address - Phone:407-775-5035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1275632084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty