Provider Demographics
NPI:1609826296
Name:SOUTH FLORIDA NEUROLOGY ASSOCIATES PA
Entity Type:Organization
Organization Name:SOUTH FLORIDA NEUROLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:C
Authorized Official - Last Name:KATZIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-939-0300
Mailing Address - Street 1:1601 CLINT MOORE RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487
Mailing Address - Country:US
Mailing Address - Phone:561-939-0300
Mailing Address - Fax:561-939-0339
Practice Address - Street 1:1601 CLINT MOORE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2768
Practice Address - Country:US
Practice Address - Phone:561-939-0300
Practice Address - Fax:561-939-0339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
FL2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL99446Medicare PIN