Organization
NEUROSCIENCE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BORIS NIKOLOV (OWNER)
(786) 310-7477
Entity
Organization
Contact information
Practice address
18330 FRANJO RD, PALMETTO BAY, FL 33157-5503
(786) 310-7477
(305) 503-9236
Mailing address
18330 FRANJO RD, PALMETTO BAY, FL 33157-5503
(786) 310-7477
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/21/2019
Last updated
02/21/2019
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