Provider Demographics
NPI:1235492679
Name:CLERMONT NEUROLOGY,PA
Entity Type:Organization
Organization Name:CLERMONT NEUROLOGY,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT /OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJPAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-989-4941
Mailing Address - Street 1:17307 PAGONIA DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5932
Mailing Address - Country:US
Mailing Address - Phone:352-989-4941
Mailing Address - Fax:352-404-6971
Practice Address - Street 1:17307 PAGONIA DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-5932
Practice Address - Country:US
Practice Address - Phone:352-989-4941
Practice Address - Fax:352-404-6971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1037282084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL08B051Medicare UPIN