Individual provider · NPI-1

Nisreen Shabbir Ezuddin, MD

Radiology, Vascular & Interventional Radiology · North Miami Beach, FL

NPI number1073017174

StatusActive

Last updated in NPPESAug 13, 2026

Details

NPI: 1073017174
Entity type: Individual (NPI-1)
Name: Nisreen Shabbir Ezuddin
Credential: MD
Sex: Female
Sole proprietor: No
Enumeration date: Mar 22, 2018
Certification date: Aug 13, 2026
Last updated: Aug 13, 2026

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
2085R0204X	Radiology, Vascular & Interventional Radiology	2025039391	MO	Yes
2085R0202X	Radiology, Diagnostic Radiology	2025039391	MO
2085R0204X	Radiology, Vascular & Interventional Radiology	0451790	KS
390200000X	Student in an Organized Health Care Education/Training Program	–	–
2085R0202X	Radiology, Diagnostic Radiology	0451790	KS
2085R0202X	Radiology, Diagnostic Radiology	ME146753	FL

Practice location

160 Nw 170th St
North Miami Beach, FL 33169-5521

Phone 305-651-1100

Mailing address

4581 Weston Rd
Weston, FL 33331-3141

Phone 305-654-5221 · Fax 305-654-6872

Other practice locations

12300 Metcalf Ave
Overland Park, KS 66213-1324

Phone 816-932-2549 · Fax 816-932-3939

1201 S Grand Blvd
Saint Louis, MO 63104-1016

Phone 314-617-2000

1611 Nw 12th Ave
Miami, FL 33136-1005

Phone 305-585-1280

5830 Nw Barry Rd
Kansas City, MO 64154-2778

Phone 816-932-2549 · Fax 816-932-3939

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