Individual
ALI GHODSIZAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 355-1684
(305) 355-5202
Mailing address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 355-1684
(305) 355-5202
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD448311
PA
208600000X
Surgery Physician
Primary
ME127851
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102836976
—
PA
Enumeration date
10/15/2008
Last updated
05/03/2016
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