Healthcare Provider Details

I. General information

NPI: 1841721628
Provider Name (Legal Business Name): IMAN DABIRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3471 N FEDERAL HWY STE 404
FORT LAUDERDALE FL
33306-1050
US

IV. Provider business mailing address

3471 N FEDERAL HWY STE 404
FORT LAUDERDALE FL
33306-1050
US

V. Phone/Fax

Practice location:
  • Phone: 754-216-8919
  • Fax: 754-216-2842
Mailing address:
  • Phone: 754-216-8919
  • Fax: 754-216-2842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME148392
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License NumberME148392
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: