Provider Demographics
NPI:1013133107
Name:TAMPA BAY NEUROLOGY CLINIC INC
Entity Type:Organization
Organization Name:TAMPA BAY NEUROLOGY CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ALAMELUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MURUGAPPAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-661-2211
Mailing Address - Street 1:413 W ROBERTSON ST STE B
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5014
Mailing Address - Country:US
Mailing Address - Phone:813-661-2211
Mailing Address - Fax:813-661-2212
Practice Address - Street 1:613 MEDICAL CARE DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5942
Practice Address - Country:US
Practice Address - Phone:813-661-2211
Practice Address - Fax:813-661-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty