Provider Demographics
NPI:1730526161
Name:NAWABI, NASEH (MD)
Entity type:Individual
Prefix:
First Name:NASEH
Middle Name:
Last Name:NAWABI
Suffix:
Gender:M
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 9851
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33075-0851
Mailing Address - Country:US
Mailing Address - Phone:818-815-9172
Mailing Address - Fax:954-755-0861
Practice Address - Street 1:10308 W SAMPLE ROAD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:818-815-9172
Practice Address - Fax:954-755-0861
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-24
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME114198207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ46994OtherARIZONA LICENSE