Provider Demographics
NPI:1649820267
Name:FLORIDA ADVANCED PRIMARY, URGENT & HOLISTIC MEDICINE LLC
Entity type:Organization
Organization Name:FLORIDA ADVANCED PRIMARY, URGENT & HOLISTIC MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ABBAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-738-0803
Mailing Address - Street 1:2522 OAK RUN BLVD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-3017
Mailing Address - Country:US
Mailing Address - Phone:407-738-0803
Mailing Address - Fax:
Practice Address - Street 1:8931 HERITAGE BAY CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-5026
Practice Address - Country:US
Practice Address - Phone:407-738-0803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty