Individual
DR. KAMRAN BADIZADEGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12252 MONTALCINO CIR, WINDERMERE, FL 34786-5672
(617) 680-4215
Mailing address
7512 DR PHILLIPS BLVD STE 50-523, ORLANDO, FL 32819-5420
(617) 680-4215
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
S99264
FL
207ZC0008X
Clinical Informatics (Pathology) Physician
Primary
111484
FL
207ZP0101X
Anatomic Pathology Physician
111484
FL
207ZP0101X
Anatomic Pathology Physician
35.129581
OH
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
97007
FL
207ZP0213X
Pediatric Pathology Physician
111484
FL
207ZP0213X
Pediatric Pathology Physician
35.129581
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3165698
—
MA
01
—
766417
TUFTS HEALTH PLAN
MA
01
—
H506762
MEDICARE PTAN
OH
01
—
J17701
BCBS MA
MA
Enumeration date
11/18/2005
Last updated
08/19/2022
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