JAX OB-GYN PA (NPI# 1891012365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1891012365 |
Entity Type | Organization |
Organization Name | JAX OB-GYN PA |
Other Organization Name | HORMOZ KHOSRAVI, MD |
Practice Address |
4123 University Blvd S. Suite D Jacksonville FL 32216 |
Practice Telephone | 9047371920 |
Practice Fax Number | 9047378932 |
Mailing Telephone | 9047371920 |
Mailing Fax Number | 9047378932 |
Enumeration Date | 2010-04-23 |
Last Update Date | 2011-12-30 |
Authorized Official Name | HORMOZ KHOSRAVI (DR./OWNER) |
Authorized Official Telephone | 9047371920 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
ME32812 | FL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 037158100 | 05 |
Other Name | Type Code |
---|---|
Hormoz Khosravi, MD | Other Name - Individual/Organization |
Street Address |
4123 UNIVERSITY BLVD S. SUITE D |
City | JACKSONVILLE |
State | FL |
Zip Code | 32216 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
Find all providers in zip 32216 |
Taxonomy Code | 207VG0400X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Obstetrics & Gynecology |
Specialization | Gynecology |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649737552 | Joe Walker Bancroft Jr. | Obstetrics & Gynecology | 4618 Long Bow Rd. South, Jacksonville, FL 32210-8144 | 2019-02-27 |
1255865036 | Dr. Frances Renee Montgomery | Obstetrics & Gynecology | 1432 Braden St Ste B, Jacksonville, AR 72076-3721 | 2017-04-18 |
1801044268 | All Women's Health Center of Jacksonville, Inc. | Obstetrics & Gynecology | 4331 University Blvd S, Jacksonville, FL 32216-4909 | 2008-08-28 |
1699985457 | Leslie Beadling | Obstetrics & Gynecology | 8160 Summit Ridge Ln, Jacksonville, FL 32256-7149 | 2007-05-23 |
1982700746 | Donald S Freedman Md Pa | Obstetrics & Gynecology | 480 Busch Dr, Jacksonville, FL 32218-5553 | 2006-09-16 |
1043313653 | The Womens Clinic | Obstetrics & Gynecology | 219 Station Street, Jacksonville, NC 28546 | 2006-09-07 |
1285677849 | Kenneth Kushner | Obstetrics & Gynecology | 5111 Baymeadows Rd, Suite 8, Jacksonville, FL 32217-4800 | 2006-06-13 |
1982665279 | Kristin P. Fernandez | Obstetrics & Gynecology | 14534 Old Saint Augustine Rd Ste 3430, Jacksonville, FL 32258-2460 | 2006-03-28 |
1790778025 | Amy E Hearne | Obstetrics & Gynecology | 7051 Southpoint Pkwy S, Suite 200, Jacksonville, FL 32216-8713 | 2005-08-23 |
1295734531 | Wilbur Cannon Simpson | Obstetrics & Gynecology | 7051 Southpoint Pkwy S Ste 200, Jacksonville, FL 32216-8713 | 2005-07-19 |
Find all providers in JACKSONVILLE |
City | JACKSONVILLE |
Zip Code | 32216 |
Please comment or provide details below to improve the information on JAX OB-GYN PA.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.