EAST COAST NEURO LLC (NPI# 1124424643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124424643 |
| Entity Type | Organization |
| Organization Name | EAST COAST NEURO LLC |
| Practice Address |
9889 Gate Pkwy N Ste 403 Jacksonville FL 32246-9228 |
| Mailing Address |
Po Box 550731 Jacksonville FL 32255-0731 |
| Practice Telephone | 9045133954 |
| Practice Fax Number | 9042120223 |
| Mailing Telephone | 8883373509 |
| Mailing Fax Number | 9413283997 |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2014-11-11 |
| Authorized Official Name | DR. VANESSA J WILCZAK (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 9152548495 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Street Address |
9889 GATE PKWY N STE 403 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32246-9228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427376805 | Rhett Butler | Chiropractor | 9889 Gate Pkwy N, Ste 401, Jacksonville, FL 32246-9228 | 2010-05-11 |
| 1063716199 | Pinnacle Alliance Home Health Care, LLC | Home Health | 9889 Gate Pkwy N, Unit 301, Jacksonville, FL 32246-9228 | 2011-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275179863 | Samar A Ibrahim | Pharmacist | 1305 N Orange Ave Green Cove Springs, Jacksonville, FL 32246 | 2019-11-19 |
| 1386290898 | Kelsey R Clevenger | Chiropractor | 4413 Town Center Parkway, Ste. 205, Jacksonville, FL 32246 | 2019-08-12 |
| 1700449006 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 4712 Lake Center Drive, Space 107, Jacksonville, FL 32246 | 2019-04-22 |
| 1205399946 | Usa United Surgical Assistants | Clinic/Center | Bahri Surgical Center, 9726 Touchton Rd, Jacksonville, FL 32246 | 2019-04-10 |
| 1780173526 | Jules Novall LLC | Taxi | 4600 Touchton Rd, Jacksonville, FL 32246 | 2018-05-08 |
| 1740636307 | Jonathan David Browning | Psychiatry & Neurology | 4884 Deer Creek Drive W, Jacksonville, FL 32246 | 2016-05-12 |
| 1952770463 | Alignment Healthcare Florida LLC | Clinic/Center | 3520-1 St. Johns Bluff Rd., Jacksonville, FL 32246 | 2015-09-15 |
| 1558739417 | Jessica Brake | Physical Therapist | 9726 Touchton Road, Suite 104, Jacksonville, FL 32246 | 2015-09-09 |
| 1043686256 | Healthyeye Dba Vision Express LLC | Optometrist | 4871 Town Center Parkway #5, Jacksonville, FL 32246 | 2015-08-12 |
| 1477954675 | Joanivette Rodriguez | Psychologist | 3451 Saland Way Apt 504, Jacksonville, FL 32246 | 2014-09-08 |
| Find all providers in zip 32246 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| 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. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285138495 | Yulia Salamatova | Psychiatry & Neurology | 580 W 8th St # T17, Jacksonville, FL 32209-6533 | 2018-03-21 |
| 1619471018 | William Joseph Scharpf | Psychiatry & Neurology | 653-1 West 8th Street, L18, 4th Floor, Lrc, Jacksonville, FL 32209 | 2018-03-20 |
| 1184155616 | Kyle Wuthrich | Psychiatry & Neurology | 580 W 8th St Fl 9, Jacksonville, FL 32209-6533 | 2017-03-26 |
| 1932511235 | Shannon Laboy | Psychiatry & Neurology | 580 W 8th St # T1-9t17, Jacksonville, FL 32209-6533 | 2014-05-21 |
| 1174933147 | Caitlin E D'souza | Psychiatry & Neurology | 14540 Old Saint Augustine Rd Ste 216, Jacksonville, FL 32258-7418 | 2014-04-30 |
| 1235416322 | Benjamin E Moore Md Pa | Psychiatry & Neurology | 2 Shircliff Way Ste 925, Jacksonville, FL 32204-4711 | 2011-11-03 |
| 1598995599 | Baptist Neurology Inc | Psychiatry & Neurology | 3563 Phillips Hwy Ste 106a, Jacksonville, FL 32207-5663 | 2009-07-24 |
| 1316104722 | Candice Waked Riggeal | Psychiatry & Neurology | 841 Prudential Dr 10th Floor, Jacksonville, FL 32207-8329 | 2008-05-22 |
| 1508089194 | James Gordon Creveling Jr | Psychiatry & Neurology | 7842 Monterey Bay Dr, Jacksonville, FL 32256-2936 | 2007-04-11 |
| 1053471987 | Mark K Emas | Psychiatry & Neurology | 4085 University Blvd South, # 3, Jacksonville, FL 32216 | 2006-12-11 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32246 |
Please comment or provide details below to improve the information on EAST COAST NEURO LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.