# THE HEADACHE AND NEUROLOGY CLINIC PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770614786
- **Authorized official:** DR. QAHTAN ABDULFATTAH MD (PRESIDENT)
- **Authorized official phone:** (352) 596-8344

## Contact information

- **Practice address:** 11373 CORTEZ BLVD STE 303, 303, BROOKSVILLE, FL 34613-5411
- **Practice address phone:** (352) 596-8344
- **Practice address fax:** (352) 597-2898
- **Mailing address:** 11373 CORTEZ BLVD STE 303, BROOKSVILLE, FL 34613-5411
- **Mailing address phone:** (352) 596-8344
- **Mailing address fax:** (352) 597-2898

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | ME92671 | FL | Yes |

## Other

- **Enumeration date:** 03/08/2007
- **Last updated:** 07/06/2010