Individual
MOHAMAD REZA SAMIIAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD PA
Contact information
Practice address
4221 SOUTHPOINT PKWY, JACKSONVILLE, FL 32216
(904) 296-2810
(904) 296-3424
Mailing address
4221 SOUTHPOINT PKWY, JACKSONVILLE, FL 32216
(904) 296-2810
(904) 296-3424
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
ME20018
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15880
PROVIDER #
FL
Enumeration date
10/18/2005
Last updated
07/08/2007
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