| Alexander Fariborzian, MD | |
|
3292 County Road 220, Middleburg, FL 32068-4357 | |
| (904) 291-5561 | |
| Not Available |
| Full Name | Alexander Fariborzian |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 3292 County Road 220, Middleburg, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710045539 | NPI | - | NPPES |
| 270881700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME 90406 (Florida) | Primary |
| Entity Name | Clay Behavioral Health Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275619488 PECOS PAC ID: 7911990353 Enrollment ID: O20040403000094 |
| Mailing Address | Practice Location Address |
|---|---|
| Alexander Fariborzian, MD 1753 Kingsley Ave, Suite 2, Orange Park, FL 32073-4411 Ph: (904) 278-5644 | Alexander Fariborzian, MD 3292 County Road 220, Middleburg, FL 32068-4357 Ph: (904) 291-5561 |
Ms. Mohini B Shukla, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 3292 County Road 220, Middleburg, FL 32068 Phone: 904-291-5561 Fax: 904-291-5572 | |
Dr. Julio G Ventura, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1658 St Vincents Way Ste 310, Middleburg, FL 32068 Phone: 904-602-4450 Fax: 904-602-4449 |