PEDIATRIC NEUROLOGY CENTER NPI 1477539807

NPI Information

  • NPI: 1477539807
  • Provider Name: PEDIATRIC NEUROLOGY CENTER
  • Classification: Psychiatry & Neurology - 2084N0402X
  • Specialization: Neurology with Special Qualifications in Child Neurology
  • Entity Type: Organization
  • Address: 5133 SOUTH LAKELAND DRIVE
    LAKELAND, FL
    ZIP 33813
  • Phone: (888) 362-2343

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NPI Details

PEDIATRIC NEUROLOGY CENTER is a neurology with special qualifications in child neurology psychiatry neurology in Lakeland, FL. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. PEDIATRIC NEUROLOGY CENTER NPI is 1477539807. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5133 SOUTH LAKELAND DRIVE
LAKELAND, FL
ZIP 33813
Phone: (888) 362-2343
Fax: (888) 388-1340

The provider's authorized official is Musarrat N Qureshi .
The authorized official title is President and has the following contact phone number (888) 362-2343.

The enumeration date for this NPI number is 12/18/2005 and was last updated on 6/17/2010.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080P0008XPediatricsNeurodevelopmental DisabilitiesNo
22084N0402XPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyME 87941FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1H96200MEDICARE UPINFLORIDA
2267392400MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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