Healthcare Provider Details

I. General information

NPI: 1962587014
Provider Name (Legal Business Name): SAUMIL RAJSHEKHAR OZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 06/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1824 KING STREET SUITE 300
JACKSONVILLE FL
32204-4736
US

IV. Provider business mailing address

1824 KING STREET SUITE 300
JACKSONVILLE FL
32204-4736
US

V. Phone/Fax

Practice location:
  • Phone: 904-388-1820
  • Fax: 904-388-1827
Mailing address:
  • Phone: 904-388-1820
  • Fax: 904-388-1827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME102318
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME102318
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: