Healthcare Provider Details

I. General information

NPI: 1669756409
Provider Name (Legal Business Name): RAMIN NAZARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2011
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 NE 13TH ST # 2G2300
OKLAHOMA CITY OK
73104-5008
US

IV. Provider business mailing address

1801 LEE RD STE 165
WINTER PARK FL
32789-2127
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-2429
  • Fax: 405-271-2421
Mailing address:
  • Phone: 407-975-0410
  • Fax: 407-975-0411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME120017
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberME120017
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberME120017
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number44096
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: