Provider Demographics
NPI:1932490240
Name:KAZI, SHAHNAZ ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAHNAZ
Middle Name:ANN
Last Name:KAZI
Suffix:
Gender:F
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:PO BOX 10744
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33757-8744
Mailing Address - Country:US
Mailing Address - Phone:727-532-0002
Mailing Address - Fax:727-266-4943
Practice Address - Street 1:5405 PARK ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-1044
Practice Address - Country:US
Practice Address - Phone:727-547-8425
Practice Address - Fax:813-635-2699
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2015-0221207Q00000X
FLME125505207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01659239OtherRAILROAD MEDICARE PROVIDER NUMBER
FL015638400Medicaid
FLII532YMedicare PIN