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NPI Code Detail

MEDICARE: DR. NASSER M KAZMOUZ MD

MEDICARE: DR. NASSER M KAZMOUZ MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianME111513FL
2207Q00000XFamily Medicine Physician48659MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
148659OTHERMNSTATE LICENCE NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508882135
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NASSER M KAZMOUZ MD
Provider Business Mailing Address
First Line : 8718 BONICA PL
Second Line :
City : LAND O LAKES
State : FL
Zip : 34637-5811
Country : US
Telephone Number : 813-503-4800
Fax Number :
Provider Business Practice Location Address
First Line : 2716 STONEWOOD PARK LOOP
Second Line :
City : LAND O LAKES
State : FL
Zip : 34638-6213
Country : US
Telephone Number : 813-873-0000
Fax Number : 813-873-3659
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2006
Last Update Date : 01/16/2025

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