MEDICARE: DR. MARYAM POURPAKI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	59857	TN

General Provider Information

NPI Number	:	1316234974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARYAM POURPAKI MD

Provider Business Mailing Address
First Line	:	2255 GLADES RD STE 228W
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33431-7391
Country	:	US
Telephone Number	:	561-320-0996
Fax Number	:

Provider Business Practice Location Address
First Line	:	4230 HARDING PIKE STE 301
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-2098
Country	:	US
Telephone Number	:	615-964-5823
Fax Number	:	615-577-1696

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2011
Last Update Date	:	06/02/2026

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