Organization
ATIT NEUROLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA EVANGELISTA CPAM,MA (ADMINISTRATOR)
(727) 937-4600
Entity
Organization
Contact information
Practice address
1011 US HIGHWAY 19, HOLIDAY, FL 34691-5636
(727) 937-4600
(727) 937-3312
Mailing address
1011 US HIGHWAY 19, HOLIDAY, FL 34691-5636
(727) 937-4600
(727) 937-3312
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0071634
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271853700
—
FL
Enumeration date
08/13/2008
Last updated
09/22/2009
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