Provider Demographics
NPI:1518478049
Name:HADZIAVDIC, EMIR
Entity Type:Individual
Prefix:
First Name:EMIR
Middle Name:
Last Name:HADZIAVDIC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7990 BAYMEADOWS RD E UNIT 1023
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-2979
Mailing Address - Country:US
Mailing Address - Phone:904-502-3558
Mailing Address - Fax:
Practice Address - Street 1:7990 BAYMEADOWS RD E UNIT 1023
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-2979
Practice Address - Country:US
Practice Address - Phone:904-502-3558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker