Provider Demographics
NPI:1497879373
Name:NEUROLOGICAL ASSOCIATES
Entity Type:Organization
Organization Name:NEUROLOGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HOOSHANG
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOSHMAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-770-9339
Mailing Address - Street 1:PO BOX 6394
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32961-6394
Mailing Address - Country:US
Mailing Address - Phone:772-770-9339
Mailing Address - Fax:
Practice Address - Street 1:4265 5TH PL
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32968-1961
Practice Address - Country:US
Practice Address - Phone:772-770-9339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00214962084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Single Specialty