Provider Demographics
NPI:1811422249
Name:NRSA GROUP PLLC
Entity Type:Organization
Organization Name:NRSA GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AZEEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-303-4354
Mailing Address - Street 1:4700 N HABANA AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-7150
Mailing Address - Country:US
Mailing Address - Phone:813-333-1353
Mailing Address - Fax:813-333-1618
Practice Address - Street 1:9360 BALM RIVERVIEW RD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-5104
Practice Address - Country:US
Practice Address - Phone:813-333-1353
Practice Address - Fax:813-333-2383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty