Organization
CENTRAL FLORIDA BREAST CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AZIZ SHAHBUDDIN JASANI M.B.A. (ADMINISTRATOR)
(407) 740-5127
Entity
Organization
Contact information
Practice address
2200 GLENWOOD DR, SUITE 201, WINTER PARK, FL 32792-3315
(407) 740-5127
(407) 740-0827
Mailing address
2200 GLENWOOD DR, SUITE 201, WINTER PARK, FL 32792-3315
(407) 740-5127
(407) 740-0827
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
OS0006978
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700176
UNITED HEALTHCARE ID
FL
01
—
5339099
AETNA ID #
FL
01
—
57169
BLUE CROSS BLUE SHIELD ID
FL
01
—
9587978
GHI ID #
FL
Enumeration date
06/25/2006
Last updated
04/25/2024
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