Healthcare Provider Details

I. General information

NPI: 1326233461
Provider Name (Legal Business Name): ALBERT NAYERI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 12/17/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 W OAKLAND PARK BLVD SUITE 309
LAUDERDALE LAKES FL
33313-7500
US

IV. Provider business mailing address

1841 NE 45TH ST
FORT LAUDERDALE FL
33308-5117
US

V. Phone/Fax

Practice location:
  • Phone: 954-678-9531
  • Fax: 954-678-9533
Mailing address:
  • Phone: 954-678-9531
  • Fax: 954-678-9533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME125222
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: