Organization
PEDIATRIC NEUROCARE INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HIMALI JAYAKODY MD (PEDIATRIC NEUROLOGIST/ CEO)
(813) 553-4448
Entity
Organization
Contact information
Practice address
170 PINE AVE N, OLDSMAR, FL 34677-4629
(480) 652-2110
Mailing address
PO BOX 320304, TAMPA, FL 33679-2304
(813) 553-4448
(813) 525-9696
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
—
—
Other
Enumeration date
04/15/2024
Last updated
08/03/2024
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