Individual
DR. NOOSHAZAR KHALVATI - KHOSRAVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4123 UNIVERSITY BLVD S, SUITE E., JACKSONVILLE, FL 32216-4371
(904) 731-5437
(904) 733-6776
Mailing address
4123 UNIVERSITY BLVD S, SUITE E., JACKSONVILLE, FL 32216-4371
(904) 731-5437
(904) 733-6776
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME41780
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15839
BCBS
—
Enumeration date
01/23/2007
Last updated
07/09/2007
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