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General NPI Number Information
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NPI Number | 1558558171
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Entity Type | Organization
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Legal Business Name | AMIR MANZOOR, MD, PA
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 08/23/2013
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Provider Practice Location Address
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Address Line | 237 E BALDWIN RD #103
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City | PANAMA CITY
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State | FL
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Zip | 32405-4205
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Country | US
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Telephone | 850-770-4051
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Fax | 850-770-4059
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Provider Business Mailing Address
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Address Line | PO BOX 15878
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City | PANAMA CITY
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State | FL
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Zip | 32406-5878
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Country | US
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Telephone | 850-770-4051
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Fax | 850-770-4059
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. AMIR MANZOOR
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Credential |
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Telephone | 850-770-4051
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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 | ME0072435
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License Number State | FL
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