Provider Demographics
NPI:1295019990
Name:NORTH CENTRAL FLORIDA NEURODIAGNOSTIC SERVICES, LLC
Entity Type:Organization
Organization Name:NORTH CENTRAL FLORIDA NEURODIAGNOSTIC SERVICES, LLC
Other - Org Name:NCF DIAGNOSTICS & DNA TECHNOLOGIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:352-375-5553
Mailing Address - Street 1:PO BOX 2459
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32616-2459
Mailing Address - Country:US
Mailing Address - Phone:352-375-5553
Mailing Address - Fax:888-972-4494
Practice Address - Street 1:12076 TECHNOLOGY AVE
Practice Address - Street 2:
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615
Practice Address - Country:US
Practice Address - Phone:352-375-5553
Practice Address - Fax:352-505-5506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-30
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL800026857291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10D2042485OtherCMS/CLIA
FL8004802OtherCOLLEGE OF AMERICAN PATHOLOGISTS
FL800026857OtherCLINICAL LABORATORY
FL605678OtherTHE JOINT COMMISSION