OrganizationActive
Neurology Center of Excellence, PLLC
NPI 1679862130 · Clinical Neurophysiology Physician · Wildwood, FL
Provider details
- NPI number
- 1679862130
- Entity type
- Organization
- Primary specialty
- Clinical Neurophysiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jonathan Carrier, Billing Manager(352) 750-6387
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
837 S Main St
Wildwood, FL 34785-5302
Phone: (352) 750-6387
Fax: (352) 753-7141
Street-level locationGet directions
Mailing address
837 S Main St
Wildwood, FL 34785-5302
Additional practice locations (1)
- 804 Highway 466Lady Lake, FL 32159-3918Phone: (352) 750-6387
Registry dates
- Enumerated
- 2011-04-05
- Last updated
- 2019-08-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.