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Individual

DR. ALI H KIZILBASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
5153 N 9TH AVE, SUITE 304, PENSACOLA, FL 32504-8785
(850) 484-7800
(850) 484-7811
Mailing address
5153 N 9TH AVE, SUITE 304, PENSACOLA, FL 32504-8785
(850) 484-7800
(850) 484-7811

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY6269
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
54621
BCBS
FL
Enumeration date
11/16/2005
Last updated
02/26/2013
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