Individual
DR. ABDUL A QAZIZADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
865 BLANDING BLVD, ORANGE PARK, FL 32065-8917
(904) 276-1133
(904) 276-1821
Mailing address
7330 IRONSIDE DR W, JACKSONVILLE, FL 32244-4466
(904) 908-4316
(904) 276-1821
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME94587
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53107
BCBS FL PROVIDER #
FL
01
—
ME94587
MEDICAL LICENSE
FL
Enumeration date
07/15/2006
Last updated
03/07/2023
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