NPIMap

Organization Active NPI

Rez Inc

  • Primary Care Clinic/Center
  • St Augustine, FL
National Provider Identifier
1457411373
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
ME0057416 Issued in FL
Legal business name
REZ INC
Practice address
1301 Plantation Island Dr S
Suite 402 B
St Augustine, FL 32080-3108
Phone
(904) 823-3777
Fax
(904) 823-3363
NPI assigned
Dec 11, 2006
Last updated
Apr 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Rezwan Rosa Ashdji, M.D.NPI 1730190042
Title
President
Phone
(904) 823-3777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X ME0057416 FL Primary

Addresses

Primary practice location

1301 Plantation Island Dr S
Suite 402 B
St Augustine, FL 32080-3108

Mailing address

1301 Plantation Island Dr S
Suite 402 B
St Augustine, FL 32080-3108
Phone (904) 823-3777

Other names 1

  • ST AUGUSTINE MEDICAL CLINIC Other name

National Provider Directory

National Provider Directory

Locations

1301 Plantation Island Dr S
Ste 402B
Saint Augustine, FL 32080
Phone (904) 325-9420

6 Saint Johns Medical Park Dr
#B
Saint Augustine, FL 32086
Phone (904) 823-3777

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430092800000",
    "number": "1457411373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S",
            "address_2": "SUITE 402 B",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320803108",
            "telephone_number": "904-823-3777",
            "fax_number": "904-823-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S",
            "address_2": "SUITE 402 B",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320803108",
            "telephone_number": "904-823-3777",
            "fax_number": "904-823-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REZ INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2015-04-27",
        "status": "A",
        "authorized_official_last_name": "ASHDJI",
        "authorized_official_first_name": "REZWAN",
        "authorized_official_middle_name": "ROSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-823-3777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME0057416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST AUGUSTINE MEDICAL CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.