Provider Demographics
NPI:1508257692
Name:UNIVERSAL NEUROLOGICAL CARE PA
Entity Type:Organization
Organization Name:UNIVERSAL NEUROLOGICAL CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:A
Authorized Official - Last Name:ASAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-404-7044
Mailing Address - Street 1:8823 SAN JOSE BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-4288
Mailing Address - Country:US
Mailing Address - Phone:904-404-7044
Mailing Address - Fax:904-329-2303
Practice Address - Street 1:8823 SAN JOSE BLVD STE 209
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-4288
Practice Address - Country:US
Practice Address - Phone:904-404-7044
Practice Address - Fax:904-329-2303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME931432084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty