Provider Demographics
NPI:1871980631
Name:NEUROLOGY ASSOCIATES OF ORMOND BEACH
Entity type:Organization
Organization Name:NEUROLOGY ASSOCIATES OF ORMOND BEACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-673-2500
Mailing Address - Street 1:8 MIRROR LAKE DR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-3101
Mailing Address - Country:US
Mailing Address - Phone:386-673-2500
Mailing Address - Fax:386-676-6349
Practice Address - Street 1:8 MIRROR LAKE DR
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-3101
Practice Address - Country:US
Practice Address - Phone:386-673-2500
Practice Address - Fax:386-676-6349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty