Organization
COUNTRYSIDE NEUROLOGY INC
Active
Organization
COUNTRYSIDE NEUROLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARDESHIR KHADEMI-KEMANSHAHI MD (PRESIDENT)
(727) 712-1567
Entity
Organization
Contact information
Practice address
2349 SUNSET POINT RD STE 403, CLEARWATER, FL 33765-1439
(727) 712-1567
Mailing address
2349 SUNSET PT RD SUITE 403, CLEARWATER, FL 34682
(727) 712-1567
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME80114
FL
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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