Ahmad G Bizri, M.D.

Individual provider Active NPI Psychiatry Physician · Bartow, FL

NPI 1477540110 · NPPES record last updated Mar 7, 2023

Key facts

NPI
1477540110
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
ME108896 (FL)
Practice address
1239 E Main St
Bartow, FL 33830-5058
Phone
(863) 519-0575
Fax
(863) 582-9251
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Highlands Community Mental Health Center, Inc. Past
since Feb 24, 2022
Accepting new patients
Peace River Center for Personal Development Inc Past
since Apr 17, 2022
Accepting new patients
Life Recovery LLC Psychiatry Past Accepting new patients
Florida Therapy Services, Inc Past
since Jul 17, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME108896 FL Yes

Addresses

Primary practice location

1239 E Main St
Bartow, FL 33830-5058

Mailing address

PO Box 1559
Bartow, FL 33831-1559
Phone (863) 519-0575

Other identifiers

IdentifierTypeStateIssuer
0116229000MedicaidWV
007108371OtherVAFIRST HEALTH
0101055878OtherVALICENSE
1064538OtherWVWV WORKERS' COMPENSATION
009689400MedicaidFL
ME108896OtherFLLICENSE

Other providers in Bartow, FL

All providers in Bartow, FL · Psychiatry Physician in Florida

Sources for this page

Verify at the official NPI Registry.