Individual
AHMAD KASRAEIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6269 BEACH BLVD, STE 2, JACKSONVILLE, FL 32216-2705
(904) 727-7955
(904) 727-7976
Mailing address
6269 BEACH BLVD, STE 2, JACKSONVILLE, FL 32216-2705
(904) 727-7955
(904) 727-7976
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
FLME 0029693
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043722100
—
FL
Enumeration date
05/24/2005
Last updated
08/02/2012
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