Provider Demographics
NPI:1174667810
Name:NEUROLOGY PARTNERS, PA
Entity Type:Organization
Organization Name:NEUROLOGY PARTNERS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:EMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-448-4180
Mailing Address - Street 1:4085 UNIVERSITY BLVD S
Mailing Address - Street 2:SUITE 3
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4357
Mailing Address - Country:US
Mailing Address - Phone:904-448-4180
Mailing Address - Fax:904-448-4181
Practice Address - Street 1:4085 UNIVERSITY BLVD S
Practice Address - Street 2:SUITE 3
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4357
Practice Address - Country:US
Practice Address - Phone:904-448-4180
Practice Address - Fax:904-448-4181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21158Medicare ID - Type UnspecifiedGROUP MEDICARE ID