Provider Demographics
NPI:1083874358
Name:NEUROLOGICAL HEALTH ASSOCIATES
Entity Type:Organization
Organization Name:NEUROLOGICAL HEALTH ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-581-8640
Mailing Address - Street 1:6735 CONROY RD SUITE 229
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835
Mailing Address - Country:US
Mailing Address - Phone:407-581-8640
Mailing Address - Fax:407-581-8659
Practice Address - Street 1:1114 CYPRESS GLEN CIRCLE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741
Practice Address - Country:US
Practice Address - Phone:407-581-8640
Practice Address - Fax:407-581-8659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME959342084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276495400Medicaid
FLAA874Medicare PIN
FLH49631Medicare UPIN