Provider Demographics
NPI:1043514953
Name:NEUROORTHOGROUP, PA
Entity Type:Organization
Organization Name:NEUROORTHOGROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PVD
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GELBARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-582-2260
Mailing Address - Street 1:2901 W CYPRESS CREEK RD
Mailing Address - Street 2:SUITE 123-124
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1730
Mailing Address - Country:US
Mailing Address - Phone:954-582-2260
Mailing Address - Fax:954-582-2808
Practice Address - Street 1:2901 W CYPRESS CREEK RD
Practice Address - Street 2:SUITE 123-124
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1730
Practice Address - Country:US
Practice Address - Phone:954-582-2260
Practice Address - Fax:954-582-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME59560261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service