Provider Demographics
NPI:1174945190
Name:NEUROHEALTH, INC.
Entity type:Organization
Organization Name:NEUROHEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCKHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-732-9643
Mailing Address - Street 1:2685 SW 32ND PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-7862
Mailing Address - Country:US
Mailing Address - Phone:352-732-9643
Mailing Address - Fax:352-732-2243
Practice Address - Street 1:2685 SW 32ND PL
Practice Address - Street 2:SUITE 100
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-7862
Practice Address - Country:US
Practice Address - Phone:352-732-9643
Practice Address - Fax:352-732-2243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-10
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA2229363A00000X
FLME427772084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty