Provider Demographics
NPI:1053831628
Name:URAZOV, KONSTANTIN (MD)
Entity Type:Individual
Prefix:
First Name:KONSTANTIN
Middle Name:
Last Name:URAZOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12350 NW 39TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-2418
Mailing Address - Country:US
Mailing Address - Phone:954-248-3422
Mailing Address - Fax:
Practice Address - Street 1:4700 SHERIDAN ST STE C
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3416
Practice Address - Country:US
Practice Address - Phone:954-961-3252
Practice Address - Fax:954-678-3007
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-23
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME145819207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine