Individual
NISREEN SHABBIR EZUDDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
160 NW 170TH ST, NORTH MIAMI BEACH, FL 33169-5521
(305) 651-1100
Mailing address
4581 WESTON RD, WESTON, FL 33331-3141
(305) 654-5221
(305) 654-6872
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0451790
KS
2085R0202X
Diagnostic Radiology Physician
2025039391
MO
2085R0202X
Diagnostic Radiology Physician
Primary
ME146753
FL
2085R0204X
Vascular & Interventional Radiology Physician
0451790
KS
2085R0204X
Vascular & Interventional Radiology Physician
2025039391
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2018
Last updated
12/17/2025
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