Individual
ARDESHIR KHADEMI-KERMANSHAHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1840 MEASE DR, SUITE 407B, SAFETY HARBOR, FL 34695-6602
(727) 712-1567
(727) 796-2719
Mailing address
PO BOX 5048, CLEARWATER, FL 33758-5048
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME80114
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272101500
—
FL
Enumeration date
10/02/2006
Last updated
07/08/2007
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