Provider Demographics
NPI:1932363785
Name:EXCEL NEUROTECH INC
Entity Type:Organization
Organization Name:EXCEL NEUROTECH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-512-4902
Mailing Address - Street 1:250 187TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2434
Mailing Address - Country:US
Mailing Address - Phone:786-512-4902
Mailing Address - Fax:305-274-0692
Practice Address - Street 1:250 187TH ST
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-2434
Practice Address - Country:US
Practice Address - Phone:786-512-4902
Practice Address - Fax:305-274-0692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic NeuroimagingGroup - Single Specialty