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General NPI Number Information
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NPI Number | 1235704065
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Entity Type | Organization
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Legal Business Name | HEALTHCARE SPECIALISTS OF FLORIDA PLLC
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 05/24/2021
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Provider Practice Location Address
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Address Line | 575 N CLYDE MORRIS BLVD STE A
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-2323
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Country | US
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Telephone | 321-355-7377
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Fax |
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Provider Business Mailing Address
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Address Line | 646 HILLS BLVD
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City | PORT ORANGE
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State | FL
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Zip | 32127-2902
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Country | US
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Telephone | 321-443-9924
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RIAZ RAHMAN
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Credential | MD
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Telephone | 321-443-9924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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