1821378712 NPI number — MAZHAR MAJID MD PA

Table of content: (NPI 1821378712)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821378712 NPI number — MAZHAR MAJID MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAZHAR MAJID MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821378712
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9105 RANCH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARKLAND
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33067-2550
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-720-1930
Provider Business Mailing Address Fax Number:
954-720-6130

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7737 N UNIVERSITY DR
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
TAMARAC
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33321-2961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-720-1930
Provider Business Practice Location Address Fax Number:
954-720-6130
Provider Enumeration Date:
08/23/2011

Additional Information

Authorized Official

Authorized Official Last Name:
MAJID
Authorized Official First Name:
MAZHAR
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
954-720-1930

Provider Taxonomy Codes

  • Taxonomy code: 207RI0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 27949 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 260850200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 107106300 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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