Provider Demographics
NPI:1598821340
Name:NEUROLOGY CONSULTANTS OF CENTRAL FLORIDA INC
Entity Type:Organization
Organization Name:NEUROLOGY CONSULTANTS OF CENTRAL FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:RH
Authorized Official - Last Name:MAMSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-847-9100
Mailing Address - Street 1:820 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-6625
Mailing Address - Country:US
Mailing Address - Phone:407-847-9100
Mailing Address - Fax:407-847-4412
Practice Address - Street 1:820 W OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-6625
Practice Address - Country:US
Practice Address - Phone:407-847-9100
Practice Address - Fax:407-847-4412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00515852084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC48783Medicare UPIN
FL04620Medicare ID - Type Unspecified