Provider Demographics
NPI:1174745095
Name:AZAR, NABIEL J (DO)
Entity type:Individual
Prefix:DR
First Name:NABIEL
Middle Name:J
Last Name:AZAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:NABIEL
Other - Middle Name:JOSEPH
Other - Last Name:AZAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO, MPH
Mailing Address - Street 1:3820 NORTHDALE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-1893
Mailing Address - Country:US
Mailing Address - Phone:813-961-1331
Mailing Address - Fax:888-812-8191
Practice Address - Street 1:3805 E BELL RD STE 4100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2172
Practice Address - Country:US
Practice Address - Phone:813-961-1331
Practice Address - Fax:888-812-8191
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ006970208600000X, 202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500624610Medicaid
ORR163316Medicare PIN