Provider Demographics
NPI:1730810664
Name:PRECISION NEUROLOGY LLC
Entity type:Organization
Organization Name:PRECISION NEUROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:AQSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-970-9584
Mailing Address - Street 1:7376 STONEROCK CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8000
Mailing Address - Country:US
Mailing Address - Phone:407-226-9766
Mailing Address - Fax:888-505-6685
Practice Address - Street 1:7376 STONEROCK CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8000
Practice Address - Country:US
Practice Address - Phone:407-226-9766
Practice Address - Fax:888-505-6685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty