Organization
SHAHRIAR A NABIZADEH MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHRIAR A NABIZADEH MD (PRESIDENT)
(904) 803-7593
Entity
Organization
Contact information
Practice address
801 OAK ST, GREEN COVE SPRINGS, FL 32043-4317
(904) 803-7593
(904) 723-5653
Mailing address
PO BOX 16373, JACKSONVILLE, FL 32245-6373
(904) 723-0015
(904) 338-0951
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252411200
—
FL
01
—
41489
BCBS
—
Enumeration date
09/18/2007
Last updated
05/31/2023
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