Basic Information
Provider Information
NPI: 1952703290
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NASIR
FirstName: AQSA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1600 SW ARCHER RD
Address2: BOX 100275
City: GAINESVILLE
State: FL
PostalCode: 32610
CountryCode: US
TelephoneNumber: 3522737839
FaxNumber:  
Practice Location
Address1: MAYO CLINIC 200 FIRST ST SW
Address2:  
City: ROCHESTER
State: MN
PostalCode: 55905
CountryCode: US
TelephoneNumber: 5072842511
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/18/2014
LastUpdateDate: 08/24/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/24/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102XME146923FLY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
207ZP0101X63128MNN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology

No ID Information.


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