Provider Demographics
NPI:1093416653
Name:PARKINSONS &NEUROLOGY CLINIC LLC
Entity Type:Organization
Organization Name:PARKINSONS &NEUROLOGY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ISRAT
Authorized Official - Middle Name:
Authorized Official - Last Name:JAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-451-7431
Mailing Address - Street 1:20248 MERRY OAK AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3642
Mailing Address - Country:US
Mailing Address - Phone:813-451-7431
Mailing Address - Fax:
Practice Address - Street 1:11700 N 58TH ST
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-1666
Practice Address - Country:US
Practice Address - Phone:813-690-6144
Practice Address - Fax:813-980-0303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty