Healthcare Provider Details

I. General information

NPI: 1730915729
Provider Name (Legal Business Name): HAMID NASSERY DMD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 ARTHUR GODFREY RD
MIAMI BEACH FL
33140-3413
US

IV. Provider business mailing address

757 ARTHUR GODFREY RD
MIAMI BEACH FL
33140-3413
US

V. Phone/Fax

Practice location:
  • Phone: 305-672-4444
  • Fax:
Mailing address:
  • Phone: 305-672-4444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. HAMIDREZA NASSERY
Title or Position: OWNER/ PROVIDER
Credential: DMD
Phone: 305-672-4444