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General NPI Number Information
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NPI Number | 1033820618
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Entity Type | Organization
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Legal Business Name | REZA HEALTH LLC
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Dates
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Enumeration Date | 12/05/2022
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 949 LANE AVE S
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City | JACKSONVILLE
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State | FL
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Zip | 32205-4706
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Country | US
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Telephone | 888-831-2949
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Fax |
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Provider Business Mailing Address
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Address Line | 81 COPPINGER PL
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City | ST JOHNS
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State | FL
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Zip | 32259-2263
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MOHAMMED REZA
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Credential | MD
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Telephone | 904-808-3688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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