Individual
NATHAN MORRIS HAMEROFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5880 49TH ST N, SUITE 104, ST PETERSBURG, FL 33709-2150
(727) 521-9552
(727) 528-4757
Mailing address
1190 80TH STREET CT S, ST PETERSBURG, FL 33707-2725
(727) 384-0395
(727) 343-5552
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME11683
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056422200
—
FL
01
—
300075305
RAILROAD MEDICARE
—
01
—
52796
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/25/2006
Last updated
04/19/2012
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