Provider Demographics
NPI:1013123231
Name:NEURO NETWORK PARTNERS
Entity Type:Organization
Organization Name:NEURO NETWORK PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMUDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-347-1888
Mailing Address - Street 1:3200 SW 60TH CT STE 302
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4071
Mailing Address - Country:US
Mailing Address - Phone:305-662-8330
Mailing Address - Fax:786-364-6811
Practice Address - Street 1:3200 SW 60TH CT STE 302
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155
Practice Address - Country:US
Practice Address - Phone:305-662-8330
Practice Address - Fax:786-364-6811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057457100Medicaid