Provider Demographics
NPI:1245288570
Name:NUEROSCIENCE ASSOCIATES OF WEST PASCO
Entity type:Organization
Organization Name:NUEROSCIENCE ASSOCIATES OF WEST PASCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-942-6511
Mailing Address - Street 1:2222 US HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34691-2635
Mailing Address - Country:US
Mailing Address - Phone:727-942-6511
Mailing Address - Fax:727-942-3312
Practice Address - Street 1:2222 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-2635
Practice Address - Country:US
Practice Address - Phone:727-942-6511
Practice Address - Fax:727-942-3312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2020-08-22
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
FL6162275OtherAETNA ENVOY
FL38930OtherBLUE CROSS BLUE SHIELD
FL6162275OtherAETNA ENVOY