Individual
TETSUO ASHIZAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 273-5550
(352) 273-5575
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 273-5550
(352) 273-5575
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
E6717
TX
2084N0400X
Neurology Physician
Primary
ME105032
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093873754
NATIONAL PROVIDER IDENTIFICATION
—
05
—
117744604
—
TX
Enumeration date
12/05/2006
Last updated
10/20/2009
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