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Individual

DR. KEYVAN NOURI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1475 NW 12 AVE, BOX 016960, MIAMI, FL 33101
(305) 243-8693
(305) 243-8470
Mailing address
1475 NW 12 AVE, BOX 016960, MIAMI, FL 33101
(305) 243-8693
(305) 243-8470

Taxonomy

Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
ME71012
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2553449-00
FL
Enumeration date
07/03/2006
Last updated
01/31/2013
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