TREASURE COAST NEUROSCIENCE AND WELLNESS CENTER LLC NPI 1093242844

NPI Information

NPI: 1093242844
Provider Name: TREASURE COAST NEUROSCIENCE AND WELLNESS CENTER LLC
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

CLIA Number: 10D0978692

Address:
1701 S 23RD ST
FORT PIERCE, FL
ZIP 34950
Phone: (772) 448-8600
Get Directions

TREASURE COAST NEUROSCIENCE AND WELLNESS CENTER LLC is a neurology psychiatry neurology in Fort Pierce, FL. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. TREASURE COAST NEUROSCIENCE AND WELLNESS CENTER LLC NPI is 1093242844. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1701 S 23RD ST
FORT PIERCE, FL
ZIP 34950-804
Phone: (772) 448-8600

The provider's authorized official is Tariq Gheith .
The authorized official title is Owner and has the following contact phone number (708) 856-2338.

The CLIA number assigned to this NPI record is 10D0978692 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/11/2017 and was last updated on 7/21/2022.

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
1	2084N0400X	Psychiatry & Neurology	Neurology	ME131849	FLORIDA	Yes

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
1	022360500	MEDICAID	FLORIDA

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: 5/5/2024

NPI Synchronization or Removal

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