Basic Information
Provider Information
NPI: 1114213329
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAZI
FirstName: SYED
MiddleName: SHAHZAD
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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Mailing Information
Address1: 2900 CORPORATE WAY
Address2: DOOR D
City: MIRAMAR
State: FL
PostalCode: 330253925
CountryCode: US
TelephoneNumber: 9542765685
FaxNumber: 9549857074
Practice Location
Address1: 1150 N 35TH AVE STE 660
Address2:  
City: HOLLYWOOD
State: FL
PostalCode: 330215471
CountryCode: US
TelephoneNumber: 9542651125
FaxNumber: 9542651133
Other Information
ProviderEnumerationDate: 06/26/2011
LastUpdateDate: 03/16/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/16/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208G00000XME140474FLY Allopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery) 

No ID Information.


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