Provider Demographics
NPI:1619118924
Name:NEUROMIND, P.A.
Entity Type:Organization
Organization Name:NEUROMIND, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:B
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD,MSCPP,LMHC
Authorized Official - Phone:305-569-0025
Mailing Address - Street 1:250 CATALONIA AVE
Mailing Address - Street 2:SUITE 801
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6735
Mailing Address - Country:US
Mailing Address - Phone:305-569-0025
Mailing Address - Fax:305-569-0018
Practice Address - Street 1:250 CATALONIA AVE
Practice Address - Street 2:SUITE 801
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6735
Practice Address - Country:US
Practice Address - Phone:305-569-0025
Practice Address - Fax:305-569-0018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6316174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty