Provider Demographics
NPI:1811967136
Name:CENTER FOR MEMORY DISORDERS, INC.
Entity type:Organization
Organization Name:CENTER FOR MEMORY DISORDERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:N.
Authorized Official - Middle Name:LOIS
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:CPH, RPH, MBA
Authorized Official - Phone:407-898-4427
Mailing Address - Street 1:3901 E COLONIAL DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5245
Mailing Address - Country:US
Mailing Address - Phone:407-447-5971
Mailing Address - Fax:407-477-5985
Practice Address - Street 1:3901 E COLONIAL DR
Practice Address - Street 2:SUITE E
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5245
Practice Address - Country:US
Practice Address - Phone:407-447-5971
Practice Address - Fax:407-477-5985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Not Answered207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Not Answered2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty