MEDICARE: NOUSHIN IZADIFAR HART 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
1	2085R0001X	Radiation Oncology Physician	L5385	TX
2	2085R0001X	Radiation Oncology Physician	036101984	IL
3	2085R0001X	Radiation Oncology Physician	0101248816	VA
4	2085R0001X	Radiation Oncology Physician	ME112142	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8B1190	OTHER	TX	MEDICARE PTAN
2	00250T	OTHER	TX	GROUP MEDICARE PIN
3	00251T	OTHER	TX	GROUP MEDICARE PIN

General Provider Information

NPI Number	:	1699775866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOUSHIN IZADIFAR HART MD

Provider Business Mailing Address
First Line	:	2776 ENTERPRISE RD
Second Line	:	SUITE 100
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8316
Country	:	US
Telephone Number	:	386-774-1223
Fax Number	:	386-774-1507

Provider Business Practice Location Address
First Line	:	2776 ENTERPRISE RD
Second Line	:	SUITE 100
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8316
Country	:	US
Telephone Number	:	386-774-1223
Fax Number	:	386-774-1507

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/05/2012

Similar Medicare Providers

1174798433 — ORANGE COUNTY NEWBORN MEDICARE CARE PC
Practice Location Address:

3 SAINT STEPHENS PL , SUITE 2
WARWICK, NY
10990-3208

Practice Phone: 845-987-9700
Practice Fax:

1538160692 — GARY ROBERT GRAHAM M.D.
Practice Location Address:

2776 ENTERPRISE RD # 100
ORANGE CITY, FL
32763-8316

Practice Phone: 386-774-1223
Practice Fax: 386-774-4658

1376528612 — ALAN R FORBES MD
Practice Location Address:

2776 ENTERPRISE RD # 100
ORANGE CITY, FL
32763-8316

Practice Phone: 386-774-1223
Practice Fax: 386-774-4658

1720037989 — GREGORY L ORTEGA MD
Practice Location Address:

2776 ENTERPRISE RD , SUITE 100
ORANGE CITY, FL
32763-8316

Practice Phone: 386-774-1223
Practice Fax: 386-774-4658

1265481428 — NEERAJ SHARMA MD
Practice Location Address:

2776 ENTERPRISE RD STE 100
ORANGE CITY, FL
32763-8316

Practice Phone: 386-774-1223
Practice Fax: 386-774-4658

1982653713 — SANTOSH M NAIR MD
Practice Location Address:

2776 ENTERPRISE ROAD , SUITE 100
ORANGE CITY, FL
32763-8316

Practice Phone: 386-774-1223
Practice Fax: 386-774-1314

Directions to “ NOUSHIN IZADIFAR HART MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.