Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251X0800X | Physical Therapist - Orthopedic | 2305005801 | VA |
NPI | 1013050939 |
---|---|
Provider Name | Dr. Mohammad Hossein Gharavi |
First Address | Clearwater, FL 33765-3952 |
Second Address | Clearwater, FL 33765-3952 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 12/01/2016 |