Organization
SPACE COAST NEUROLOGY AND PAIN MANAGEMENT PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MASOOD HASHMI MD (OWNER)
(321) 984-7997
Entity
Organization
Contact information
Practice address
4951 BABCOCK ST NE, SUITE 1, PALM BAY, FL 32905-2821
(321) 984-7997
(321) 984-7935
Mailing address
4951 BABCOCK ST NE, SUITE 1, PALM BAY, FL 32905-2821
(321) 984-7997
(321) 984-7935
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ARNP 9203833
FL
174400000X
Specialist
Primary
ME0072245
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269085300
—
FL
Enumeration date
12/18/2006
Last updated
05/22/2008
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