Provider Demographics
NPI:1871052753
Name:USMANOVA, NAZOKAT (MD)
Entity type:Individual
Prefix:
First Name:NAZOKAT
Middle Name:
Last Name:USMANOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8525 SW 92ND ST STE D13
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7378
Mailing Address - Country:US
Mailing Address - Phone:305-270-3562
Mailing Address - Fax:
Practice Address - Street 1:8525 SW 92ND ST STE D13
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7378
Practice Address - Country:US
Practice Address - Phone:305-270-3562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME165591207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL91389660Medicaid