Individual
ALI M. BOZORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 TAMPA GENERAL CIR, TAMPA, FL 33606-3603
(813) 974-8577
Mailing address
PO BOX 917770, J402, ORLANDO, FL 32891-7770
(813) 974-8577
(813) 259-8551
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME101207
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009141100
—
FL
01
—
145RT
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/25/2007
Last updated
08/31/2011
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