Provider Demographics
NPI:1144181041
Name:ELEMENT NEURO INSTITUTE, LLC
Entity type:Organization
Organization Name:ELEMENT NEURO INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-401-8094
Mailing Address - Street 1:6220 S ORANGE BLOSSOM TRL STE 161
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-4677
Mailing Address - Country:US
Mailing Address - Phone:407-401-8094
Mailing Address - Fax:
Practice Address - Street 1:6220 S ORANGE BLOSSOM TRL STE 161
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-4677
Practice Address - Country:US
Practice Address - Phone:407-401-8094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELEMENT HOLDINGS GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P0301XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationBrain Injury MedicineGroup - Multi-Specialty