MEDICARE: DR. AZADEH KHOSRAVI ZIARANI M.D.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ACN1312	FL
2	207R00000X	Internal Medicine Physician	021637	PR
3	208D00000X	General Practice Physician	ACN1312	FL
4	390200000X	Student in an Organized Health Care Education/Training Program

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	:	1891177432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AZADEH KHOSRAVI ZIARANI M.D.

Provider Business Mailing Address
First Line	:	5400 PINEHURST DR
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34606-3833
Country	:	US
Telephone Number	:	352-277-5348
Fax Number	:	352-606-2857

Provider Business Practice Location Address
First Line	:	4270 LAKE IN THE WOODS DR
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34607-2501
Country	:	US
Telephone Number	:	352-597-7249
Fax Number	:	352-597-9523

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2015
Last Update Date	:	11/20/2025

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