Organization
LEILA PATALLO
Active
Other names
Titusville Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DELPHINE CELINE JACQUET (OFFICE MANAGER)
(321) 383-0900
Entity
Organization
Contact information
Practice address
1781 GARDEN ST, TITUSVILLE, FL 32796-3221
(321) 383-0900
(321) 383-0024
Mailing address
1781 GARDEN ST, TITUSVILLE, FL 32796-3221
(321) 383-0900
(321) 383-0024
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME84982
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13868
BLUE CROSS BLUE SHIELD
FL
01
—
3956438
AETNA GROUP NUMBER
FL
01
—
7735972
CIGNA
FL
01
—
7835391
AETNA
FL
01
—
DD8925
PALMETTO GBA GROUP NUMBER
FL
Enumeration date
09/27/2007
Last updated
06/18/2008
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