Organization
FLORIDA NEUROLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMPATHKUMAR SHANMUGHAM M.D. (PRESIDENT)
(407) 333-1718
Entity
Organization
Contact information
Practice address
755 STIRLING CENTER PLACE, LAKE MARY, FL 32746
(407) 333-1718
(407) 333-1633
Mailing address
755 STIRLING CENTER PLACE, LAKE MARY, FL 32746
(407) 333-1718
(407) 333-1633
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376958500
—
FL
Enumeration date
05/23/2005
Last updated
03/24/2011
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