Organization
JACKSONVILLE COSMETIC SURGRY CENTER
Active
Other names
PLASTIC AND COSMETIC SURGERY CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. A.H. NEZAMI M.D. (PRESIDENT)
(904) 399-5061
Entity
Organization
Contact information
Practice address
820 PRUDENTIAL DR, SUITE 702, JACKSONVILLE, FL 32207-8210
(904) 399-5061
(904) 399-5062
Mailing address
820 PRUDENTIAL DR, SUITE 702, JACKSONVILLE, FL 32207-8210
(904) 399-5061
(904) 399-5062
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138
OFFICE SERGERY REGISTRATI
FL
Enumeration date
08/31/2006
Last updated
08/22/2020
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