Provider Demographics
NPI:1811360233
Name:NEUROSCIENCE CENTERS OF FLORIDA FOUNDATION, INC.
Entity type:Organization
Organization Name:NEUROSCIENCE CENTERS OF FLORIDA FOUNDATION, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HORSTMYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-856-8940
Mailing Address - Street 1:2150 CORAL WAY
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2629
Mailing Address - Country:US
Mailing Address - Phone:305-856-8940
Mailing Address - Fax:305-456-3797
Practice Address - Street 1:2150 CORAL WAY
Practice Address - Street 2:8TH FLOOR
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-2629
Practice Address - Country:US
Practice Address - Phone:305-856-8940
Practice Address - Fax:305-456-3797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty