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Contact Information

PBH PROFESSIONAL GROUP, P.A.
1200 W GRANADA BLVD STE 1A
ORMOND BEACH, FL32174-8157
 Phone: 386-506-8110
 Fax: 386-463-2170
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Medicine

2083A0300X 84 Physician/Preventive Medicine
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for PBH PROFESSIONAL GROUP, P.A.

NPI # 1912670647
LBN Legal business name PBH PROFESSIONAL GROUP, P.A.
Authorized official FLORA SADRI-AZARBAYEJANI - (PRESIDENT AND SECRETARY)
Entity Organization
Organization subpart 1 No
Enumeration date 07/28/2021
Last updated 07/28/2021 - About 5 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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