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Organization
SOUTH FLORIDA NEUROLOGICAL
Active
Organization
SOUTH FLORIDA NEUROLOGICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE CICCONE (OWNER)
(954) 941-1399
Entity
Organization
Contact information
Practice address
601 E SAMPLE RD STE 104, POMPANO BEACH, FL 33064-4443
(954) 941-1399
(954) 941-3103
Mailing address
601 E SAMPLE RD STE 104, POMPANO BEACH, FL 33064-4443
(954) 941-1399
(954) 941-3103
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
HCC5957
FL
Other
Enumeration date
11/13/2007
Last updated
11/13/2007
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