Organization
FLORIDA PHYSICIAN SPECIALISTS LLC
Active
Other names
Kasraeian Urology
Organization subpart
No
Provider details
NPI number
Authorized official
AHMAD KASRAEIAN MD (CEO)
(904) 727-7955
Entity
Organization
Contact information
Practice address
6269 BEACH BLVD, SUITE 2, JACKSONVILLE, FL 32216-2768
(904) 727-7955
(904) 727-7976
Mailing address
6269 BEACH BLVD, SUITE 2, JACKSONVILLE, FL 32216-2768
(904) 727-7955
(904) 727-7976
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
—
—
Other
Enumeration date
12/10/2012
Last updated
12/10/2012
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