| Organization Name: | NEUROSPECT OF FLORIDA |
| NPI Number: | 1093128084 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRIAN BALDWIN (OWNER) |
| Mailing Address: | 109 S Park Ave Titusville |
| State: | FL US |
| Postal Code: | 327963377 |
| Phone Number: | 3212661881 |
| Fax Number: | |
| NPI Enumeration Date: | 06/06/2014 |
| NPI Last Update Date: | 06/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1200X |
| License Number: | CRT49346 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Magnetic Resonance Imaging (MRI) |
| Taxonomy Definition: | |