Amiridze, Nana S

Amiridze, Nana S is an individual health care provider with primary practice located at 1251 S Hickory St , Melbourne FL 32901-3221. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Neuroradiology. Allopathic & Osteopathic Physicians / Neuroradiology is her primary health care specialty. Amiridze, Nana S can be contacted via phone (321) 434-3420.

Contact Information

Primary practice address
1251 S Hickory St Melbourne FL 32901-3221
Phone: (321) 434-3420
Fax: (321) 434-3423
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X D0060165 Maryland
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X ME105768 Florida
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X ME105768 Florida

Profile Details

NPI number 1447246509
LBN Legal business name Amiridze, Nana S
Credentials MD, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Jan 2nd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447246509 NPPES
Maryland MEDICAID 405376100
Maryland Other 60340002
Maryland Other 0063
Maryland MEDICAID 001680100

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