Alexander Fariborzian, MD | |
3292 County Road 220, Middleburg, FL 32068-4357 | |
(904) 291-5561 | |
Not Available |
Full Name | Alexander Fariborzian |
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Gender | Male |
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 3292 County Road 220, Middleburg, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710045539 | NPI | - | NPPES |
270881700 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
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2084P0800X | Psychiatry & Neurology - Psychiatry | ME 90406 (Florida) | Primary |
Entity Name | Clay Behavioral Health Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275619488 PECOS PAC ID: 7911990353 Enrollment ID: O20040403000094 |
Mailing Address | Practice Location Address |
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Alexander Fariborzian, MD 1753 Kingsley Ave, Suite 2, Orange Park, FL 32073-4411 Ph: (904) 278-5644 | Alexander Fariborzian, MD 3292 County Road 220, Middleburg, FL 32068-4357 Ph: (904) 291-5561 |
Ms. Mohini B Shukla, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 3292 County Road 220, Middleburg, FL 32068 Phone: 904-291-5561 Fax: 904-291-5572 | |
Dr. Julio G Ventura, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1658 St Vincents Way Ste 310, Middleburg, FL 32068 Phone: 904-602-4450 Fax: 904-602-4449 |