Provider Demographics
NPI:1336313238
Name:NEUROPSYCHOLOGY ASSESMENT SERVICES
Entity Type:Organization
Organization Name:NEUROPSYCHOLOGY ASSESMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KRISTJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OLAFSSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:407-765-5141
Mailing Address - Street 1:4700 MILLENIA BLVD
Mailing Address - Street 2:SUITE 175
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-6013
Mailing Address - Country:US
Mailing Address - Phone:407-765-5141
Mailing Address - Fax:
Practice Address - Street 1:4700 MILLENIA BLVD
Practice Address - Street 2:SUITE 175
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-6013
Practice Address - Country:US
Practice Address - Phone:407-765-5141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6548103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54788Medicare PIN