Provider Demographics
NPI:1356830566
Name:NEURO ENERGY CORPORATION
Entity Type:Organization
Organization Name:NEURO ENERGY CORPORATION
Other - Org Name:NEURO ENERGY CORPORATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DORA
Authorized Official - Middle Name:DEL CARMEN
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-255-2234
Mailing Address - Street 1:8210 SW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2425
Mailing Address - Country:US
Mailing Address - Phone:786-255-2234
Mailing Address - Fax:
Practice Address - Street 1:8210 SW 29TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2425
Practice Address - Country:US
Practice Address - Phone:786-255-2234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center