Individual
AHMAD SHAH BARAKZOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2035 PROFESSIONAL CENTER DR STE A, ORANGE PARK, FL 32073-4462
(904) 579-3578
(904) 375-8568
Mailing address
2035 PROFESSIONAL CENTER DR STE A, ORANGE PARK, FL 32073-4462
(904) 579-3578
(904) 375-8568
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME94217
FL
207RN0300X
Nephrology Physician
Primary
ME94217
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273911900
—
FL
Enumeration date
09/13/2006
Last updated
10/27/2023
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