Provider Demographics
NPI:1821300344
Name:NEUROLOGY OFFICES OF SOUTH FLORIDA PLLC
Entity Type:Organization
Organization Name:NEUROLOGY OFFICES OF SOUTH FLORIDA PLLC
Other - Org Name:BRIAN A COSTELL MD PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:NEUROLOGIST/CEO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:COSTELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-482-1027
Mailing Address - Street 1:9970 CENTRAL PARK BLVD N
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-2231
Mailing Address - Country:US
Mailing Address - Phone:561-482-1027
Mailing Address - Fax:561-482-1028
Practice Address - Street 1:9970 CENTRAL PARK BLVD N
Practice Address - Street 2:SUITE 207
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-2231
Practice Address - Country:US
Practice Address - Phone:561-482-1027
Practice Address - Fax:561-482-1028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME909002084N0400X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty