{"npi":"1124028915","type":"NPI-2","status":"active","name":{"display":"Neurologic Consultants, PA","other":[],"organization_name":"NEUROLOGIC CONSULTANTS, PA","authorised_official":"Jullius Ancheta"},"specialty":{"primary_taxonomy":"2084N0400X","primary_taxonomy_description":"Neurology","slug":"neurology","schema_org_specialty":"Neurologic","all":[{"code":"2084N0400X","description":"Neurology","primary":true,"state":"FL","license":"ME80512"}]},"addresses":[{"purpose":"LOCATION","street_1":"517 RIVIERA ST","city":"VENICE","state":"FL","postal_code":"342852827","country_code":"US","street_2":"SUITE A","phone":"9414121208","fax":"9414121248"},{"purpose":"MAILING","street_1":"517 RIVIERA ST","city":"VENICE","state":"FL","postal_code":"342852827","country_code":"US","street_2":"SUITE A","phone":"9414121208","fax":"9414121248"}],"license":{"state":"FL","number":"ME80512"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"264553000","state":"FL","issuer":null},{"type_code":"01","label":"Other","value":"58680","state":"FL","issuer":"BCBS"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20110927000337","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"FL","pac_id":"5698946416"}]},"enumeration_date":"2005-07-22","last_updated":"2009-11-23","_meta":{"source":"NPPES","snapshot_date":"2009-11-23","doc_url":"https://findmynpi.com/api"}}