Organization
NEUROLOGY HEADACHE ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC F STAKEBAKE PA (OWNER)
(801) 603-8002
Entity
Organization
Contact information
Practice address
6500 N SOCRUM LOOP RD STE 200, LAKELAND, FL 33809-4179
(863) 853-3331
Mailing address
6500 N SOCRUM LOOP RD STE 200, LAKELAND, FL 33809-4179
(863) 853-3331
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
12/20/2022
Last updated
09/06/2023
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