Provider Demographics
NPI:1245082742
Name:RELIABLE NEURO DIAGNOSTICS CORP
Entity type:Organization
Organization Name:RELIABLE NEURO DIAGNOSTICS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARANZOLA
Authorized Official - Suffix:
Authorized Official - Credentials:R EEG T, CLTM
Authorized Official - Phone:054-074-7633
Mailing Address - Street 1:761 VISTA MEADOWS DR FL 33327
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-1835
Mailing Address - Country:US
Mailing Address - Phone:305-407-4763
Mailing Address - Fax:954-541-5963
Practice Address - Street 1:761 VISTA MEADOWS DR FL 33327
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33327-1835
Practice Address - Country:US
Practice Address - Phone:305-407-4763
Practice Address - Fax:954-541-5963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEGGroup - Multi-Specialty