MEDICARE: REZA HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QC1500X	Community Health Clinic/Center
2	363L00000X	Nurse Practitioner
3	251B00000X	Case Management Agency
4	207RI0200X	Infectious Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033820618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REZA HEALTH LLC

Provider Business Mailing Address
First Line	:	945 LANE AVE S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32205-4706
Country	:	US
Telephone Number	:	888-831-2949
Fax Number	:	833-973-6210

Provider Business Practice Location Address
First Line	:	945 LANE AVE S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32205-4706
Country	:	US
Telephone Number	:	888-831-2949
Fax Number	:	833-973-6210

Authorized Official
Title or Position	:	OWNER
Name	:	MOHAMMED REZA
Credential	:	MD
Telephone Number	:	904-808-3688

Provider Enumeration Date	:	12/05/2022
Last Update Date	:	06/01/2026

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Directions to “REZA HEALTH LLC ” Practice Location

Language	Start Address	Practice Location

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