Provider Demographics
NPI:1821647769
Name:NEUROCLINICS, LLC
Entity Type:Organization
Organization Name:NEUROCLINICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMER
Authorized Official - Middle Name:ISAAC
Authorized Official - Last Name:MOSQUERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-622-7725
Mailing Address - Street 1:7300 SW 93RD AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3212
Mailing Address - Country:US
Mailing Address - Phone:786-383-0173
Mailing Address - Fax:307-242-1124
Practice Address - Street 1:7300 SW 93RD AVE STE 210
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3212
Practice Address - Country:US
Practice Address - Phone:786-383-0173
Practice Address - Fax:307-242-1124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-04
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty