MEDICARE: FLORIDA HEADACHE & MIGRAINE MEDICINE GROUP PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1245161884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA HEADACHE & MIGRAINE MEDICINE GROUP PLLC

Provider Business Mailing Address
First Line	:	5020 N 36TH CT
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-2233
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5020 N 36TH CT
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-2233
Country	:	US
Telephone Number	:	516-304-6001
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICHELLE WEBER
Credential	:	FNP
Telephone Number	:	516-304-6001

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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