Organization
NEUROLOGY & NEURODIAGNOSTIC CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATA BANSAL (M.D.)
(407) 228-0220
Entity
Organization
Contact information
Practice address
2909 N ORANGE AVENUE,, SUITE 109, ORLANDO, FL 32804
(407) 228-0220
(407) 228-4668
Mailing address
2909 N. ORANGE AVE, #109, ORLANDO, FL 32804
(407) 228-0220
(407) 228-4668
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME58038
FL
Other
Enumeration date
10/24/2011
Last updated
01/25/2016
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