Healthcare Provider Details

I. General information

NPI: 1508176587
Provider Name (Legal Business Name): AKLILU AND COBIAN INFECTIOUS DISEASES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 01/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 E COMMERCIAL BLVD STE 203
FORT LAUDERDALE FL
33308-3807
US

IV. Provider business mailing address

2151 E COMMERCIAL BLVD STE 203
FORT LAUDERDALE FL
33308-3807
US

V. Phone/Fax

Practice location:
  • Phone: 954-498-2260
  • Fax: 954-498-2261
Mailing address:
  • Phone: 954-498-2260
  • Fax: 954-498-2261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: YARED AKLILU
Title or Position: OWNER
Credential: MD
Phone: 954-812-4980