Healthcare Provider Details

I. General information

NPI: 1215961107
Provider Name (Legal Business Name): NAVID VAHIDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N ORANGE AVE
ORLANDO FL
32804-5531
US

IV. Provider business mailing address

1900 N ORANGE AVE
ORLANDO FL
32804-5531
US

V. Phone/Fax

Practice location:
  • Phone: 407-896-8990
  • Fax: 407-896-6034
Mailing address:
  • Phone: 407-896-8990
  • Fax: 407-896-6034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME96638
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: