Provider Demographics
NPI:1023056033
Name:CENTRAL FLORIDA NEUROLOGIC CONSULTANTS, P.A.
Entity type:Organization
Organization Name:CENTRAL FLORIDA NEUROLOGIC CONSULTANTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENDRIK
Authorized Official - Middle Name:
Authorized Official - Last Name:DINKLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-736-8622
Mailing Address - Street 1:742 W PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-3282
Mailing Address - Country:US
Mailing Address - Phone:386-736-8622
Mailing Address - Fax:386-738-7629
Practice Address - Street 1:742 W PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-3282
Practice Address - Country:US
Practice Address - Phone:386-736-8622
Practice Address - Fax:386-738-7629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID NUMBER
FL=========OtherTAX ID NUMBER