Basic Information
| Provider Information | |||||||||
| NPI: | 1336496322 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FLORIDA NEUROLOGY ASSOCIATES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2402 | ||||||||
| Address2: | |||||||||
| City: | GOLDENROD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327332402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073412294 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3665 E BAY DRIVE | ||||||||
| Address2: | |||||||||
| City: | LARGO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337711990 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073412294 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2012 | ||||||||
| LastUpdateDate: | 10/19/2012 | ||||||||
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| AuthorizedOfficialLastName: | ZAMAN | ||||||||
| AuthorizedOfficialFirstName: | MOHAMMED | ||||||||
| AuthorizedOfficialMiddleName: | N | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 4073412294 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | OS11044 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.