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General NPI Number Information
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NPI Number | 1366757825
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Entity Type | Organization
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Legal Business Name | DR NICK AUSAF FAMILY PRACTICE PA
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Dates
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Enumeration Date | 08/09/2010
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Last Update Date | 12/30/2011
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Provider Practice Location Address
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Address Line | 5 RYANT BLVD
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City | SEBRING
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State | FL
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Zip | 33870-8075
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Country | US
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Telephone | 863-402-1001
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Fax | 863-402-9097
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Provider Business Mailing Address
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Address Line | PO BOX 8057
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City | SEBRING
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State | FL
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Zip | 33872-0118
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Country | US
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Telephone | 863-402-1001
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Fax | 863-402-9097
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. NIAZ AMER AUSAF
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Credential | DO
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Telephone | 863-402-1001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS7734
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License Number State | FL
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