BEHZAD RAZAVI, MD, PA
Osteopathic Medicine at Mack Bayou Rd, Santa Rosa Beach, FL

License number
Florida ME113682
Category
Osteopathic Medicine
Type
Infectious Disease
Owner
Name: DR. BEHZAD RAZAVI MD
Title: OWNER
Phone: (850) 830-9452
Address
Address 2
870 Mack Bayou Rd, Santa Rosa Beach, FL 32459
755 Grand Blvd SUITE B105-195, Destin, FL 32550
National Provider ID: 1366854317
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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BEHZAD RAZAVI, M.D., PA

2006 Crystal Lk Dr, Miramar Beach, FL 32550

Registration:
Sep 23, 2013
State ID:
P13000078250
Business type:
Florida Profit Corporation
Director, President, Secretary, Treasurers:
Razavi, Behzad, M.d, 2006 Crystal Lk Dr, Miramar Beach, FL 32550 (Physical),Behzad M. Razavi (Director, President, Secretary, Treasurer)
Agent:
Kevin M. Helmich,4405 Commons Dr E SUITE 102, Destin, FL 32541 (Physical)
EIN:
46-3729395

Behzad Razavi, M.D., PA

1418 Baytowne Cir E, Destin, FL 32550

Industry:
Medical Doctor's Office, Offices and Clinics of Medical Doctors, N

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