Provider Demographics
NPI:1811876576
Name:SHAHBAZI, REZA
Entity type:Individual
Prefix:MR
First Name:REZA
Middle Name:
Last Name:SHAHBAZI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 EASTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-1522
Mailing Address - Country:US
Mailing Address - Phone:216-538-0922
Mailing Address - Fax:
Practice Address - Street 1:1376 LANDER RD
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-1654
Practice Address - Country:US
Practice Address - Phone:216-538-0922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health