Individual
SAMIRA RAZAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5650 BOLLETTIERI BLVD, BRADENTON, FL 34210-2211
(941) 524-3778
Mailing address
101 3RD AVE W, BRADENTON, FL 34205-8688
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2-4943
ZZ
Other
Enumeration date
01/31/2023
Last updated
01/31/2023
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