Organization
KASRAEIAN UROLOGY LLC
Active
Other names
Ahmad Kasraeian MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AHMAD KASRAEIAN M.D. (PRESIDENT)
(904) 727-7955
Entity
Organization
Contact information
Practice address
6269 BEACH BLVD, SUITE 2, JACKSONVILLE, FL 32216-2768
(904) 727-7955
(904) 727-7976
Mailing address
6269 BEACH BLVD, SUITE 2, JACKSONVILLE, FL 32216-2768
(904) 727-7955
(904) 727-7976
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39658
BCBS OF FLORIDA GROUP
FL
Enumeration date
07/10/2008
Last updated
10/03/2008
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