Healthcare Provider Details

I. General information

NPI: 1457771461
Provider Name (Legal Business Name): ALI NASIR DO, FACOI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2014
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3229 E. ATLANTIC BLVD.
POMPANO BEACH FL
33062-5012
US

IV. Provider business mailing address

3229 E ATLANTIC BLVD
POMPANO BEACH FL
33062-5012
US

V. Phone/Fax

Practice location:
  • Phone: 954-908-9959
  • Fax:
Mailing address:
  • Phone: 954-908-9959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number17984
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number15691
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: