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Organization
MAAZALI LLC
Active
Organization
MAAZALI LLC
Active
Other names
BROOKSVILLE PRIMARY CARE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SYED WAJAHAT ALI M.D. (PRESIDENT)
(352) 797-9677
Entity
Organization
Contact information
Practice address
14540 CORTEZ BLVD, SUITE # 116, BROOKSVILLE, FL 34613-6056
(352) 797-9677
(352) 797-9857
Mailing address
11451 CORTEZ BLVD, BROOKSVILLE, FL 34613-7367
(352) 797-9677
(352) 600-8913
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME83482
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264459200
—
FL
Enumeration date
03/13/2008
Last updated
09/19/2024
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