Provider Demographics
NPI:1467926006
Name:IDEAL NEUROLOGY CLINIC, PLLC
Entity Type:Organization
Organization Name:IDEAL NEUROLOGY CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER/CEO/MEDICAL DIRECTO
Authorized Official - Prefix:
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHALFIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-961-8575
Mailing Address - Street 1:PO BOX 880761
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33488-0761
Mailing Address - Country:US
Mailing Address - Phone:561-961-8575
Mailing Address - Fax:561-898-1710
Practice Address - Street 1:7000 W PALMETTO PARK RD STE 406
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3425
Practice Address - Country:US
Practice Address - Phone:561-961-8575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty