Healthcare Provider Details

I. General information

NPI: 1396430294
Provider Name (Legal Business Name): NADER NOURAEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6363 MANATEE AVE W
BRADENTON FL
34209-2373
US

IV. Provider business mailing address

102 WOODMONT BLVD STE 600
NASHVILLE TN
37205-5250
US

V. Phone/Fax

Practice location:
  • Phone: 941-297-2931
  • Fax: 941-297-2212
Mailing address:
  • Phone: 888-987-1151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME183162
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: