Provider Demographics
NPI:1124368675
Name:STROKE AND BRAIN SPECIALISTS PA
Entity Type:Organization
Organization Name:STROKE AND BRAIN SPECIALISTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HAMMESFAHR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-217-7425
Mailing Address - Street 1:1950 LAUREL MANOR DR
Mailing Address - Street 2:BLDG 200 STE 206
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-5603
Mailing Address - Country:US
Mailing Address - Phone:352-414-5322
Mailing Address - Fax:
Practice Address - Street 1:1950 LAUREL MANOR DR
Practice Address - Street 2:BLDG 200 STE 206
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5603
Practice Address - Country:US
Practice Address - Phone:352-414-5322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME522122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D-21184Medicare UPIN
07247Medicare PIN