Provider Demographics
NPI:1942433834
Name:NEUROLOGY & PAIN MEDICINE INC
Entity Type:Organization
Organization Name:NEUROLOGY & PAIN MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARRASCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-224-9487
Mailing Address - Street 1:1380 N KROME AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034-2406
Mailing Address - Country:US
Mailing Address - Phone:305-224-9487
Mailing Address - Fax:305-224-9491
Practice Address - Street 1:1380 N KROME AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-2406
Practice Address - Country:US
Practice Address - Phone:305-224-9487
Practice Address - Fax:305-224-9491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME821902084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty