Healthcare Provider Details

I. General information

NPI: 1568239176
Provider Name (Legal Business Name): AZZ MEDICAL ASSOCIATES, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 GULF BLVD APT 101
CLEARWATER BEACH FL
33767-2795
US

IV. Provider business mailing address

PO BOX 830826
PHILADELPHIA PA
19182-0826
US

V. Phone/Fax

Practice location:
  • Phone: 609-890-1050
  • Fax: 609-890-0950
Mailing address:
  • Phone: 609-890-1050
  • Fax: 609-890-0950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SHAHID MEER
Title or Position: OWNER OF ENTITY
Credential: MD
Phone: 609-943-8806