Provider Demographics
NPI:1851588958
Name:NEUROCARE CONSULTANTS INC
Entity Type:Organization
Organization Name:NEUROCARE CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CANAVES NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-624-0702
Mailing Address - Street 1:PO BOX 33225
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33420-3225
Mailing Address - Country:US
Mailing Address - Phone:561-624-0702
Mailing Address - Fax:561-624-0773
Practice Address - Street 1:601 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2788
Practice Address - Country:US
Practice Address - Phone:561-624-0702
Practice Address - Fax:561-624-0773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0050280174400000X
FLME84122174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05739OtherBCBS
FL4122062OtherAETNA
FL0581875OtherUNITED HEALTH CARE
FLK0423Medicare PIN