Provider Demographics
NPI:1326478033
Name:NEUROCARE INC.
Entity Type:Organization
Organization Name:NEUROCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HUBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ZACHARY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:904-281-1066
Mailing Address - Street 1:9838 OLD BAYMEADOWS RD
Mailing Address - Street 2:SUITE 386
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-8101
Mailing Address - Country:US
Mailing Address - Phone:904-281-1066
Mailing Address - Fax:904-281-1060
Practice Address - Street 1:1895 KINGSLEY AVE
Practice Address - Street 2:SUITE 901
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4466
Practice Address - Country:US
Practice Address - Phone:904-281-1066
Practice Address - Fax:904-281-1060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic