Provider Demographics
NPI:1447307459
Name:NORTH FLORIDA NEUROSURGERY LLC
Entity type:Organization
Organization Name:NORTH FLORIDA NEUROSURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:CLAUD
Authorized Official - Last Name:CAUTHEN
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:352-331-0811
Mailing Address - Street 1:PO BOX 198799
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8799
Mailing Address - Country:US
Mailing Address - Phone:352-331-0811
Mailing Address - Fax:352-332-6387
Practice Address - Street 1:6510 NW 9TH BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4274
Practice Address - Country:US
Practice Address - Phone:352-331-0811
Practice Address - Fax:352-332-6387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0012242174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01850WMedicare PIN
DG3902Medicare PIN
FLAE089Medicare PIN
FLD50232Medicare UPIN