Provider Demographics
NPI:1033574140
Name:NEUROLOGY CHILDREN'S LLC
Entity Type:Organization
Organization Name:NEUROLOGY CHILDREN'S LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERMANO
Authorized Official - Middle Name:
Authorized Official - Last Name:FALCAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-278-2401
Mailing Address - Street 1:2984 ALAFAYA TRL
Mailing Address - Street 2:SUITE 2020
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-7628
Mailing Address - Country:US
Mailing Address - Phone:407-278-2401
Mailing Address - Fax:407-278-2402
Practice Address - Street 1:2984 ALAFAYA TRL
Practice Address - Street 2:SUITE 2020
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-7628
Practice Address - Country:US
Practice Address - Phone:407-278-2401
Practice Address - Fax:407-278-2402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-17
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME125808261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015902200Medicaid