| Neurological Specialties Neurology Pa | |
|
2816 W Virginia Ave Tampa FL 33607-6330 | |
| (813) 876-6321 | |
| (813) 870-0350 |
| Full Name | Neurological Specialties Neurology Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2816 W Virginia Ave, Tampa, Florida |
| Authorized Official Name and Position | Thomas M Newman (PRESIDENT) |
| Authorized Official Contact | 8138766321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurological Specialties Neurology Pa 2816 W Virginia Ave Tampa FL 33607-6330 Ph: (813) 876-6321 | Neurological Specialties Neurology Pa 2816 W Virginia Ave Tampa FL 33607-6330 Ph: (813) 876-6321 |
| NPI Number | 1932167566 |
|---|---|
| Provider Enumeration Date | 05/03/2006 |
| Last Update Date | 01/15/2015 |
| Medicare PECOS PAC ID | 6709936107 |
|---|---|
| Medicare Enrollment ID | O20090605000142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932167566 | NPI | - | NPPES |
| 1932167566 | Other | NPI | |
| 21271 | Other | MEDICARE GROUP NUMBER | |
| 21271 | Other | FL | BCBS OF FLORIDA GROUP NUM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Brody L Henkel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164511168 PECOS PAC ID: 0941479331 Enrollment ID: I20110801000311 |
| Provider Name | Demetrios Konstas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124394382 PECOS PAC ID: 9436439015 Enrollment ID: I20161219000835 |
| Provider Name | Alexis Leigh Kozich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427550045 PECOS PAC ID: 7517220122 Enrollment ID: I20180412002802 |
| Provider Name | Wahid Tazudeen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104008606 PECOS PAC ID: 5698927341 Enrollment ID: I20211007001344 |
| Provider Name | Denise Joan Algarin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700455458 PECOS PAC ID: 4284073057 Enrollment ID: I20240413000361 |
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