Provider Demographics
NPI:1184026312
Name:NEUROLOGY PARTNERS, P.A.
Entity type:Organization
Organization Name:NEUROLOGY PARTNERS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:EMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-448-4174
Mailing Address - Street 1:4085 UNIVERSITY BLVD S
Mailing Address - Street 2:SUITE 3
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4357
Mailing Address - Country:US
Mailing Address - Phone:904-448-4174
Mailing Address - Fax:904-448-4177
Practice Address - Street 1:4085 UNIVERSITY BLVD S
Practice Address - Street 2:SUITE 3
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4357
Practice Address - Country:US
Practice Address - Phone:904-448-4174
Practice Address - Fax:904-448-4177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67970332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21158Medicare UPIN