Provider Demographics
NPI:1215961107
Name:VAHIDI, NAVID (MD)
Entity type:Individual
Prefix:
First Name:NAVID
Middle Name:
Last Name:VAHIDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 N ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5531
Mailing Address - Country:US
Mailing Address - Phone:407-896-8990
Mailing Address - Fax:407-896-6034
Practice Address - Street 1:1900 N ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5531
Practice Address - Country:US
Practice Address - Phone:407-896-8990
Practice Address - Fax:407-896-6034
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96638207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL06114OtherBLUE CROSS BLUE SHIELD
FLU8738ZMedicare PIN
FL06114OtherBLUE CROSS BLUE SHIELD