MEDICARE: NINA KAZEMI

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	235Z00000X	Speech-Language Pathologist	SZ 4180	FL

General Provider Information

NPI Number	:	1699978759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NINA KAZEMI

Provider Business Mailing Address
First Line	:	1455 WEST AVE
Second Line	:	APT. 404
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-3779
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1455 WEST AVE
Second Line	:	# 404
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-3779
Country	:	US
Telephone Number	:	305-531-5298
Fax Number	:

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

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	07/08/2007

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Directions to “ NINA KAZEMI ” Practice Location

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