Provider Demographics
NPI:1851837728
Name:NASERI MEDICAL SERVICES, INC
Entity Type:Organization
Organization Name:NASERI MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:IMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NASERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-595-7475
Mailing Address - Street 1:6817 SOUTHPOINT PKWY STE 502
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-6289
Mailing Address - Country:US
Mailing Address - Phone:904-595-7475
Mailing Address - Fax:904-595-7480
Practice Address - Street 1:6817 SOUTHPOINT PKWY STE 502
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6289
Practice Address - Country:US
Practice Address - Phone:904-595-7475
Practice Address - Fax:904-595-7480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-16
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME105498207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty