Provider Demographics
NPI:1578218095
Name:NEUROLOGIC CONSULTANTS LLC
Entity Type:Organization
Organization Name:NEUROLOGIC CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:GAREWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-676-6335
Mailing Address - Street 1:325 CLYDE MORRIS BLVD STE 390
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8179
Mailing Address - Country:US
Mailing Address - Phone:386-676-6335
Mailing Address - Fax:386-256-7629
Practice Address - Street 1:325 CLYDE MORRIS BLVD STE 390
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8179
Practice Address - Country:US
Practice Address - Phone:386-676-6335
Practice Address - Fax:386-256-7629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty