Provider Demographics
NPI:1164036901
Name:NEURO DIAGNOSTIC CENTERS INC.
Entity Type:Organization
Organization Name:NEURO DIAGNOSTIC CENTERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:386-569-6459
Mailing Address - Street 1:704 E MOODY BLVD UNIT 1742
Mailing Address - Street 2:
Mailing Address - City:BUNNELL
Mailing Address - State:FL
Mailing Address - Zip Code:32110-6122
Mailing Address - Country:US
Mailing Address - Phone:386-243-7560
Mailing Address - Fax:
Practice Address - Street 1:766 DELTONA BLVD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-7107
Practice Address - Country:US
Practice Address - Phone:862-437-5603
Practice Address - Fax:386-259-5931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Multi-Specialty