Provider Demographics
NPI:1649096892
Name:NEUROCARE CENTER, LLC
Entity type:Organization
Organization Name:NEUROCARE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARESA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUGO MONTALVO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-485-8242
Mailing Address - Street 1:675 AVENUE L SE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-4219
Mailing Address - Country:US
Mailing Address - Phone:863-485-8242
Mailing Address - Fax:863-220-7522
Practice Address - Street 1:675 AVENUE L SE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-4219
Practice Address - Country:US
Practice Address - Phone:863-485-8242
Practice Address - Fax:863-220-7522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty