Healthcare Provider Details
I. General information
NPI: 1770064552
Provider Name (Legal Business Name): BRAIN AND STROKE CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/28/2018
Last Update Date: 06/19/2020
Certification Date: 06/19/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2900 FELICIA ST STE 103
NASHVILLE TN
37209-4043
US
IV. Provider business mailing address
2900 FELICIA ST STE 103
NASHVILLE TN
37209-4043
US
V. Phone/Fax
- Phone: 615-450-6758
- Fax: 908-282-3384
- Phone: 615-450-6758
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2081P0301X |
| Taxonomy | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SRAVANI
VENKATA ANJANA
MEHTA
Title or Position: PHYSICIAN
Credential: MD
Phone: 615-450-6758