JAX OB-GYN PA NPI 1891012365

NPI Information

JAX OB-GYN PA is a gynecology obstetrics gynecology in Jacksonville, FL. 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.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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