Individual
BAHARAK KHABAZGHAZVINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP-BC
Contact information
Practice address
5901 SW 74TH ST STE 408, SOUTH MIAMI, FL 33143-5164
(305) 735-3555
(954) 990-7650
Mailing address
1400 E OAKLAND PARK BLVD STE 210, OAKLAND PARK, FL 33334-4400
(954) 561-6222
(954) 990-7650
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11004948
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104945400
—
FL
Enumeration date
11/07/2019
Last updated
06/07/2023
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