SOUTHEASTERN NEUROSCIENCE INSTITUTE PA NPI 1700099017

NPI Information

SOUTHEASTERN NEUROSCIENCE INSTITUTE PA is a specialist in Jacksonville, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SOUTHEASTERN NEUROSCIENCE INSTITUTE PA NPI is 1700099017. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3728 PHILLIPS HWY
SUITE 31
JACKSONVILLE, FL
ZIP 32207-300
Phone: (904) 346-0707
Fax: (904) 396-4300

The provider's authorized official is Jacob Green .
The authorized official title is Ceo, Neurologist and has the following contact phone number (904) 346-0707.

The enumeration date for this NPI number is 5/7/2007 and was last updated on 5/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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