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General NPI Number Information
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NPI Number | 1215006085
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Entity Type | Individual
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Provider Name | HAMIDREZA A. NASSERY DMD
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Gender | Male
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 03/16/2011
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Provider Practice Location Address
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Address Line | 757 ARTHUR GODFREY RD
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3413
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Country | US
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Telephone | 305-672-4444
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Fax | 305-672-8997
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Provider Business Mailing Address
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Address Line | 757 ARTHUR GODFREY RD
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3413
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Country | US
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Telephone | 305-672-4444
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Fax | 305-672-8997
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN13372
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License Number State | FL
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