Provider Demographics
NPI:1538256953
Name:NASIR, SHAZIA (MD)
Entity type:Individual
Prefix:DR
First Name:SHAZIA
Middle Name:
Last Name:NASIR
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 501
Mailing Address - Street 2:
Mailing Address - City:GOTHA
Mailing Address - State:FL
Mailing Address - Zip Code:34734-0501
Mailing Address - Country:US
Mailing Address - Phone:352-243-3433
Mailing Address - Fax:352-243-3044
Practice Address - Street 1:1950 HOSPITAL VIEW WAY
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1926
Practice Address - Country:US
Practice Address - Phone:352-243-3443
Practice Address - Fax:352-243-3044
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0088336207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH94041Medicare UPIN