1457493819 NPI number — DR. FAUJIA ZAMAN SOBHAN M.D.

Table of content: DR. FAUJIA ZAMAN SOBHAN M.D. (NPI 1457493819)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457493819 NPI number — DR. FAUJIA ZAMAN SOBHAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOBHAN
Provider First Name:
FAUJIA
Provider Middle Name:
ZAMAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZAMAN
Provider Other First Name:
FAUJIA
Provider Other Middle Name:
AKHTAR
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1457493819
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/08/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1065 NE 125TH ST STE 409
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33161-5834
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-852-6672
Provider Business Mailing Address Fax Number:
786-235-6225

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10301 HAGEN RANCH ROAD
Provider Second Line Business Practice Location Address:
B6
Provider Business Practice Location Address City Name:
BOYNTON BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33437-3723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-752-9490
Provider Business Practice Location Address Fax Number:
561-752-9491
Provider Enumeration Date:
02/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  22670 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: ME98237 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 244578 . This is a "MIDLANDS CHOICE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: D06244 . This is a "BCBS" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 279814000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: AG589Z . This is a "MEDICARE PTAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 47079687527 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 47079687531 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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