Individual
KASRA R BADIOZAMANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
60 MEMORIAL MEDICAL PKWY, PALM COAST, FL 32164-5980
(386) 586-2060
Mailing address
2501 N ORANGE AVE STE 182, ORLANDO, FL 32804-4675
(407) 303-2030
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
1563-320
WI
2085R0001X
Radiation Oncology Physician
MD00040513
WA
2085R0001X
Radiation Oncology Physician
Primary
ME154391
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039587
LABOR & INDUSTRY
WA
01
—
6050BH
BLUE SHIELD
WA
05
—
8298531
—
WA
01
—
MD5014W
ALASKA MEDICAID
WA
01
—
P00818961
RAILROAD MEDICARE
—
01
—
US7036111
AETNA/USHC SPECIALIST
WA
Enumeration date
08/25/2006
Last updated
08/02/2023
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