Provider Demographics
NPI:1164030359
Name:NEUROSURSERY & ORTHOPEDIC INSTITUTE OF FLORIDA LLC
Entity Type:Organization
Organization Name:NEUROSURSERY & ORTHOPEDIC INSTITUTE OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMOS
Authorized Official - Middle Name:O
Authorized Official - Last Name:DARE
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:561-844-0120
Mailing Address - Street 1:8185 VIA ANCHO RD
Mailing Address - Street 2:UNIT 880347
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33488
Mailing Address - Country:US
Mailing Address - Phone:561-844-0120
Mailing Address - Fax:904-743-9225
Practice Address - Street 1:644 CESERY BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211
Practice Address - Country:US
Practice Address - Phone:904-743-9222
Practice Address - Fax:904-743-9225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty