Provider Demographics
NPI:1326233461
Name:NAYERI, ALBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:
Last Name:NAYERI
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 1:1841 NE 45TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-5117
Mailing Address - Country:US
Mailing Address - Phone:954-678-9531
Mailing Address - Fax:954-678-9533
Practice Address - Street 1:4900 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 309
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-7500
Practice Address - Country:US
Practice Address - Phone:954-678-9531
Practice Address - Fax:954-678-9533
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME125222207RC0001X, 207RC0001X
CT045675208M00000X
NY255462207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015591100Medicaid
FLIK507ZMedicare PIN
NYJ400075554Medicare PIN
FLIK507ZMedicare PIN
FL015591100Medicaid