Organization
SOUTHEAST NEUROLOGY GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE G LEVY M.D. (PRESIDENT)
(954) 341-1171
Entity
Organization
Contact information
Practice address
9750 NW 33RD ST, STE 107, CORAL SPRINGS, FL 33065-4042
(954) 341-1171
(954) 968-5005
Mailing address
PO BOX 25218, TAMARAC, FL 33320-5218
(954) 341-1171
(954) 968-5005
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME35865
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065077300
—
FL
Enumeration date
08/13/2009
Last updated
08/13/2009
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