Provider Demographics
NPI:1811129901
Name:AFSHARI, ALIREZA (DC)
Entity type:Individual
Prefix:DR
First Name:ALIREZA
Middle Name:
Last Name:AFSHARI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 STATE ROAD 436 STE 2080
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-5343
Mailing Address - Country:US
Mailing Address - Phone:770-912-3234
Mailing Address - Fax:
Practice Address - Street 1:500 STATE ROAD 436 STE 2080
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5343
Practice Address - Country:US
Practice Address - Phone:407-951-7666
Practice Address - Fax:407-951-7666
Is Sole Proprietor?:No
Enumeration Date:2009-08-22
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10047111N00000X
VA0104556521111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor