Individual
DR. SAMIRA KHAZRAVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1200 RIVERPLACE BLVD, 620, JACKSONVILLE, FL 32207-9046
(904) 396-6620
(904) 396-6528
Mailing address
1200 RIVERPLACE BLVD, 620, JACKSONVILLE, FL 32207-9046
(904) 396-6620
(904) 396-6528
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
245885
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME100775
FL
Other
Enumeration date
09/04/2007
Last updated
11/22/2013
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