Provider Demographics
NPI:1831134071
Name:KAZI, OMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:
Last Name:KAZI
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 1:2822 S ALAFAYA TRL STE 150
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7972
Mailing Address - Country:US
Mailing Address - Phone:407-674-7333
Mailing Address - Fax:407-663-0306
Practice Address - Street 1:2822 S ALAFAYA TRL STE 150
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7972
Practice Address - Country:US
Practice Address - Phone:407-674-7333
Practice Address - Fax:407-663-0306
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81029207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35925OtherBCBS
FLP00205715OtherRR MEDICARE
FL259758600Medicaid
FL0497943OtherGHI
FL39574Medicare PIN