Organization
INNERVATE NEUROLOGY CLINIC, INC.
Active
Organization
INNERVATE NEUROLOGY CLINIC, INC.
Active
Other names
Innervate Muscle and Nerve Specialist
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AURELIO A MUZAURIETA JR. (PRESIDENT)
(904) 631-2669
Entity
Organization
Contact information
Practice address
14810 OLD SAINT AUGUSTINE RD, SUITE 207B, JACKSONVILLE, FL 32258-2451
(904) 298-2525
(904) 677-7873
Mailing address
PO BOX 1450, ORANGE PARK, FL 32067-1450
(904) 298-2525
(904) 677-7873
Taxonomy
Speciality
Code
Description
License number
State
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
ME122880
FL
2084N0400X
Neurology Physician
Primary
ME122880
FL
2084N0600X
Clinical Neurophysiology Physician
ME122880
FL
Other
Enumeration date
08/14/2015
Last updated
08/14/2015
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