Provider Demographics
NPI:1649484429
Name:KABIR, RIZWANUL (MD)
Entity type:Individual
Prefix:
First Name:RIZWANUL
Middle Name:
Last Name:KABIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1564 KINGSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4521
Mailing Address - Country:US
Mailing Address - Phone:904-264-0400
Mailing Address - Fax:904-264-0401
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-2025
Practice Address - Country:US
Practice Address - Phone:248-821-3178
Practice Address - Fax:248-821-3178
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD438984207L00000X
FLME108908207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology