Healthcare Provider Details

I. General information

NPI: 1487660247
Provider Name (Legal Business Name): SAINT PETERSBURG NEUROLOGY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SAINT PETERSBURG NEUROLOGY CLINIC 1099 5TH AVE. N. STE 300
SAINT PETERSBURG FL
33705-1419
US

IV. Provider business mailing address

1099 5TH AVE N STE. 300
SAINT PETERSBURG FL
33705-1469
US

V. Phone/Fax

Practice location:
  • Phone: 727-820-7701
  • Fax: 727-820-7700
Mailing address:
  • Phone: 727-820-7701
  • Fax: 727-820-7700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL A. FRANKLIN
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 727-820-7701