Provider Demographics
NPI:1518701903
Name:NEURO EMMAAR CORP
Entity type:Organization
Organization Name:NEURO EMMAAR CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EVARISTO
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTALVO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-720-6984
Mailing Address - Street 1:8353 SW 124TH ST STE 208
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-5847
Mailing Address - Country:US
Mailing Address - Phone:786-250-5607
Mailing Address - Fax:786-250-5611
Practice Address - Street 1:8353 SW 124TH ST STE 208
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-5847
Practice Address - Country:US
Practice Address - Phone:786-250-5607
Practice Address - Fax:786-250-5611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty