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Individual

AHMAD NEMATBAKHSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
5880 49TH ST N, STE 104, ST PETERSBURG, FL 33709-2150
(727) 528-6100
(727) 528-7895
Mailing address
5880 49TH ST N, STE 104, ST PETERSBURG, FL 33709-2150
(727) 528-6100
(727) 528-7895

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
OS9206
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
43227V
MEDICARE PTAN
FL
Enumeration date
06/03/2006
Last updated
03/17/2018
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