NPI:
1891012365
Provider Name:
JAX OB-GYN PA
Other Name: HORMOZ KHOSRAVI, MD
Classification:
Obstetrics & Gynecology - 207VG0400X
Entity Type:
Organization
Specialization: Gynecology
Address:
4123 UNIVERSITY BLVD S.
SUITE D
JACKSONVILLE, FL
ZIP 32216
Phone:
(904) 737-1920
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JAX OB-GYN PA is a gynecology obstetrics gynecology in Jacksonville, FL. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions.
Source: National Uniform Claim Committee JAX OB-GYN PA NPI is 1891012365. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Hormoz Khosravi, Md.
The provider's business location address is:
4123 UNIVERSITY BLVD S.
SUITE D
JACKSONVILLE, FL
ZIP 32216
Phone: (904) 737-1920
Fax: (904) 737-8932
The provider's authorized official is Hormoz Khosravi .
The authorized official title is Dr./owner and has the following contact phone number (904) 737-1920.
The enumeration date for this NPI number is 4/23/2010 and was last updated on 12/30/2011.