Organization
NEUROPLACE P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VESNA MICIC M.D. (PRESIDENT)
(832) 370-3789
Entity
Organization
Contact information
Practice address
6290 BETTY AVE, COCOA, FL 32927-4202
(321) 301-4299
(321) 301-4299
Mailing address
6290 BETTY AVE, COCOA, FL 32927-4202
(321) 301-4299
(321) 301-4299
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
ME104201
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002469900
—
FL
Enumeration date
04/01/2014
Last updated
04/01/2014
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