Provider Demographics
NPI:1932627171
Name:NEURO CONSULTANTS LLC
Entity Type:Organization
Organization Name:NEURO CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN-SELF
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCZYNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-542-1412
Mailing Address - Street 1:9960 NW 116TH WAY STE 13
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1175
Mailing Address - Country:US
Mailing Address - Phone:786-924-1311
Mailing Address - Fax:786-924-1313
Practice Address - Street 1:3502 KYOTO GARDENS DRIVE
Practice Address - Street 2:SUTIE A
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410
Practice Address - Country:US
Practice Address - Phone:561-776-8891
Practice Address - Fax:866-436-2183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1168452084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty