Provider Demographics
NPI:1700839453
Name:NEUROLOGY& NEUROSURGERY ASSOCIATES
Entity Type:Organization
Organization Name:NEUROLOGY& NEUROSURGERY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-293-2100
Mailing Address - Street 1:50 2ND ST SE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-6300
Mailing Address - Country:US
Mailing Address - Phone:863-293-2100
Mailing Address - Fax:863-595-4227
Practice Address - Street 1:50 2ND ST SE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-6300
Practice Address - Country:US
Practice Address - Phone:863-293-2100
Practice Address - Fax:863-595-4227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X, 363AS0400X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1700839453OtherNPI
FL370017800Medicaid
FL1700839453OtherNPI
FL370017800Medicaid