Healthcare Provider Details

I. General information

NPI: 1689779472
Provider Name (Legal Business Name): ARIF WAJID M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 WEST SAMPLE ROAAD SUITE# 122
COCONUT CREEK FL
33073
US

IV. Provider business mailing address

2560 NW 124TH AVE
CORAL SPRINGS FL
33065-7819
US

V. Phone/Fax

Practice location:
  • Phone: 954-978-6130
  • Fax: 954-978-2113
Mailing address:
  • Phone: 954-340-1182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME0071221
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: