Provider Demographics
NPI:1104387935
Name:REMYELIX NEUROLOGY & MULTIPLE SCLEROSIS INSTITUTE, PLLC
Entity Type:Organization
Organization Name:REMYELIX NEUROLOGY & MULTIPLE SCLEROSIS INSTITUTE, PLLC
Other - Org Name:PATHWAY NEUROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ARLIN
Authorized Official - Last Name:RUMBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-549-1475
Mailing Address - Street 1:4907 N FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-2119
Mailing Address - Country:US
Mailing Address - Phone:813-549-1675
Mailing Address - Fax:813-549-4175
Practice Address - Street 1:4907 N FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-2119
Practice Address - Country:US
Practice Address - Phone:813-549-1675
Practice Address - Fax:813-549-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-26
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1528093705OtherINDIVIDUAL NPI