Healthcare Provider Details

I. General information

NPI: 1750971164
Provider Name (Legal Business Name): ZAHRA ALI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MEDICAL PARK DR E
BIRMINGHAM AL
35235-3401
US

IV. Provider business mailing address

7751 BELFORT PKWY STE 120
JACKSONVILLE FL
32256-6921
US

V. Phone/Fax

Practice location:
  • Phone: 904-372-3943
  • Fax: 904-212-1618
Mailing address:
  • Phone: 904-372-3943
  • Fax: 904-212-1618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number1-133665
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-133665
License Number StateAL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: