Provider Demographics
NPI:1164544011
Name:NEUROLOGY CONSULTANTS INC
Entity Type:Organization
Organization Name:NEUROLOGY CONSULTANTS INC
Other - Org Name:VINOD D DESHMUKH MD PHD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VINOD
Authorized Official - Middle Name:D
Authorized Official - Last Name:DESHMUKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:904-808-0406
Mailing Address - Street 1:PO BOX 860069
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086
Mailing Address - Country:US
Mailing Address - Phone:904-808-0406
Mailing Address - Fax:904-808-0504
Practice Address - Street 1:300 HEALTH PARK BLVD
Practice Address - Street 2:SUITE 5010
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086
Practice Address - Country:US
Practice Address - Phone:904-808-0406
Practice Address - Fax:904-808-0504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME326742084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21833Medicare ID - Type Unspecified
D52607Medicare UPIN