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General NPI Number Information
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NPI Number | 1487687257
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Entity Type | Individual
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Provider Name | SOHRAB AFSHARI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 10/05/2012
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Provider Practice Location Address
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Address Line | 2311 UNIVERSITY BLVD W
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2022
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Country | US
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Telephone | 904-636-0200
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Fax | 904-636-5783
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Provider Business Mailing Address
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Address Line | 2311 UNIVERSITY BLVD W
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2022
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Country | US
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Telephone | 904-636-0200
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Fax | 904-636-5783
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | ME36017
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License Number State | FL
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