Bashirimoghaddam, Adel

Bashirimoghaddam, Adel is an individual health care provider with primary practice located at 1600 Sw Archer Rd , Gainesville FL 32610-2616. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Bashirimoghaddam, Adel can be contacted via phone (352) 273-8610.

Contact Information

Primary practice address
1600 Sw Archer Rd Gainesville FL 32610-2616
Phone: (352) 273-8610
Fax: (352) 273-8612
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X RN9413485 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APRN11017560 Florida

Profile Details

NPI number 1518537612
LBN Legal business name Bashirimoghaddam, Adel
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2021
Last updated Jun 13th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518537612 NPPES
Florida MEDICAID 113461900

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