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Provider Information for 1508264417

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

MR. ENVER RUZDIJA ARNP-C

Gender: MALE

Individual NPI: 1508264417

Calendar   Last Updated:  2019-08-27
  Certification Date: 

Details

Name Value
NPI 1508264417
Enumeration Date 2014-12-09
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 2995 DREW ST FL 2
CLEARWATER, FL 33759-3012
United States

Phone: 727-532-1355 | Fax: 813-635-2613
View Map External Link
Primary Practice Address 2350 SUNSET POINT RD STE C
CLEARWATER, FL 33765
United States

Phone: 727-797-3155 | Fax: 727-797-4301
View Map External Link
Secondary Practice Address 900 CARILLON PKWY STE 402B
ST PETERSBURG, FL 33716
United States

Phone: 727-561-2505 | Fax:
View Map External Link

Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID FL 016077200
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 363LA2200X - Nurse Practitioner Adult Health FL ARNP9264115