Provider Demographics
NPI:1073225181
Name:THE RIAZ CLINIC
Entity Type:Organization
Organization Name:THE RIAZ CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:RIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-495-9560
Mailing Address - Street 1:3342 NE 34TH ST
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-6906
Mailing Address - Country:US
Mailing Address - Phone:954-358-2363
Mailing Address - Fax:954-306-2232
Practice Address - Street 1:3342 NE 34TH ST
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-6906
Practice Address - Country:US
Practice Address - Phone:954-358-2363
Practice Address - Fax:954-306-2232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty