1790267607 NPI number — OMAR KAZI, MD, OPHTHALMOLOGY ASSOCIATES, PA

Table of content: (NPI 1790267607)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790267607 NPI number — OMAR KAZI, MD, OPHTHALMOLOGY ASSOCIATES, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OMAR KAZI, MD, OPHTHALMOLOGY ASSOCIATES, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790267607
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/28/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1237 HASLEY PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MELBOURNE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32940-6020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
321-271-4641
Provider Business Mailing Address Fax Number:
321-676-8469

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2822 S ALAFAYA TRL STE 150
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32828-7972
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-271-4641
Provider Business Practice Location Address Fax Number:
321-676-8469
Provider Enumeration Date:
09/06/2018

Additional Information

Authorized Official

Authorized Official Last Name:
KAZI
Authorized Official First Name:
OMAR
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
321-271-4641

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com