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General NPI Number Information
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NPI Number | 1811372972
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Entity Type | Organization
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Legal Business Name | NAZARI, LLC
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Dates
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Enumeration Date | 07/29/2015
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | 105 BONNIE LOCH CT SUITE A
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City | ORLANDO
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State | FL
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Zip | 32806-2909
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Country | US
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Telephone | 407-245-3636
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Fax | 407-245-3667
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Provider Business Mailing Address
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Address Line | 105 BONNIE LOCH CT SUITE A
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City | ORLANDO
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State | FL
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Zip | 32806-2909
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Country | US
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Telephone | 407-245-3636
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KOUROSH NAZARI
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Credential | M.D.
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Telephone | 407-470-9798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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