Provider Demographics
NPI:1790453173
Name:NEUROSCIENCE CONSULTANTS LLP
Entity Type:Organization
Organization Name:NEUROSCIENCE CONSULTANTS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:LANNY
Authorized Official - Middle Name:E
Authorized Official - Last Name:PAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-924-1311
Mailing Address - Street 1:PO BOX 160010
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-0001
Mailing Address - Country:US
Mailing Address - Phone:786-924-1311
Mailing Address - Fax:786-924-1313
Practice Address - Street 1:8720 N KENDALL DR STE 211
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2198
Practice Address - Country:US
Practice Address - Phone:305-273-3007
Practice Address - Fax:305-273-3913
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEUROSCIENCE CONSULTANTS LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102142202Medicaid