Provider Demographics
NPI:1639232119
Name:PREMIER NEUROLOGICAL TREATMENT CENTERS INC
Entity Type:Organization
Organization Name:PREMIER NEUROLOGICAL TREATMENT CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEEDLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-424-3581
Mailing Address - Street 1:8320 W SUNRISE BLVD
Mailing Address - Street 2:SUITE #109
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322
Mailing Address - Country:US
Mailing Address - Phone:954-424-3581
Mailing Address - Fax:954-424-3198
Practice Address - Street 1:8320 W SUNRISE BLVD
Practice Address - Street 2:SUITE #109
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322
Practice Address - Country:US
Practice Address - Phone:954-424-3581
Practice Address - Fax:954-424-3198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60483261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation