Provider Demographics
NPI:1215099528
Name:NEUROLOGICAL TESTING CENTERS OF AMERICA INC.
Entity type:Organization
Organization Name:NEUROLOGICAL TESTING CENTERS OF AMERICA INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FARAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:KHURSHEED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-748-7474
Mailing Address - Street 1:10000 STIRLING ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8067
Mailing Address - Country:US
Mailing Address - Phone:954-748-7474
Mailing Address - Fax:954-748-7772
Practice Address - Street 1:10000 STIRLING ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33024-8067
Practice Address - Country:US
Practice Address - Phone:954-748-7474
Practice Address - Fax:954-748-7772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC4519208100000X
208VP0014X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33766Medicare ID - Type Unspecified