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Organization

NEUROLOGY INSTITUTE OF MELBOURNE PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD MAHLON UNGER JR. M.D. (OWNER/PHYSICIAN)
(321) 725-6999
Entity
Organization

Contact information

Practice address
116 SILVER PALM AVE, MELBOURNE, FL 32901-3172
(321) 725-6999
(321) 725-6981
Mailing address
PO BOX 459, MELBOURNE, FL 32902-0459
(321) 725-6999
(321) 725-6981

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME80168
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
259417000
FL
01
35458
BLUE CROSS
FL
Enumeration date
05/19/2006
Last updated
01/17/2013
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