Provider Demographics
NPI:1891708152
Name:FLORIDA NEUROLOGY CENTER OF ORLANDO
Entity Type:Organization
Organization Name:FLORIDA NEUROLOGY CENTER OF ORLANDO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:COMITER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-382-6292
Mailing Address - Street 1:7824 LAKE UNDERHILL RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8201
Mailing Address - Country:US
Mailing Address - Phone:407-382-6292
Mailing Address - Fax:407-382-6280
Practice Address - Street 1:7824 LAKE UNDERHILL RD
Practice Address - Street 2:SUITE H
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8201
Practice Address - Country:US
Practice Address - Phone:407-382-6292
Practice Address - Fax:407-382-6280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0019625174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL058623400Medicaid
FL058623400Medicaid
FLD58774Medicare UPIN