Provider Demographics
NPI:1467404467
Name:BOZKIR, IHSAN NACI (MD)
Entity Type:Individual
Prefix:
First Name:IHSAN
Middle Name:NACI
Last Name:BOZKIR
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 1:1045 N COURTENAY PKWY
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-4531
Mailing Address - Country:US
Mailing Address - Phone:321-453-3937
Mailing Address - Fax:855-816-8467
Practice Address - Street 1:1045 N COURTENAY PKWY
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4531
Practice Address - Country:US
Practice Address - Phone:321-453-3937
Practice Address - Fax:855-816-8467
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0058054207W00000X
OH35-06-2154207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0894457Medicaid
001714080OtherMOUNTAIN STATE BCBS
WV0095659000Medicaid
180015951OtherRR MEDICARE
OH310917085047OtherCARESOURCE MEDICAID
OH0894457OtherMOLINA MEDICAID
000000007745OtherANTHEM BCBS
OH000000181582OtherUNISON MEDICAID
OH0729583Medicare PIN
001714080OtherMOUNTAIN STATE BCBS