Healthcare Provider Details

I. General information

NPI: 1427792951
Provider Name (Legal Business Name): NRSA GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 N HABANA AVE STE 202
TAMPA FL
33614-7150
US

IV. Provider business mailing address

9360 BALM RIVERVIEW RD
RIVERVIEW FL
33569-5104
US

V. Phone/Fax

Practice location:
  • Phone: 813-333-1353
  • Fax: 813-333-1618
Mailing address:
  • Phone: 813-333-1353
  • Fax: 813-333-1618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NOMEN AZEEM
Title or Position: DOCTOR/CEO
Credential: MD
Phone: 813-333-1353