Provider Demographics
NPI:1346230372
Name:NEUROCARE INSTITUTE OF CENTRAL FLORIDA, P.A.
Entity Type:Organization
Organization Name:NEUROCARE INSTITUTE OF CENTRAL FLORIDA, P.A.
Other - Org Name:NEUROCARE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PINELESS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:407-657-7900
Mailing Address - Street 1:1890 STATE ROAD 436
Mailing Address - Street 2:SUITE 255
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2285
Mailing Address - Country:US
Mailing Address - Phone:407-657-7900
Mailing Address - Fax:407-657-7942
Practice Address - Street 1:1890 STATE ROAD 436
Practice Address - Street 2:SUITE 255
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2285
Practice Address - Country:US
Practice Address - Phone:407-657-7900
Practice Address - Fax:407-657-7942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-21
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS-00050872084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1659Medicare PIN