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General NPI Number Information
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NPI Number | 1477540110
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Entity Type | Individual
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Provider Name | AHMAD G BIZRI M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1239 E MAIN ST
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City | BARTOW
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State | FL
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Zip | 33830-5058
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Country | US
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Telephone | 863-519-0575
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Fax | 863-582-9251
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Provider Business Mailing Address
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Address Line | PO BOX 1559
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City | BARTOW
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State | FL
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Zip | 33831-1559
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Country | US
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Telephone | 863-519-0575
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Fax | 863-582-9251
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME108896
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License Number State | FL
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