Healthcare Provider Details

I. General information

NPI: 1174967822
Provider Name (Legal Business Name): AJAY DHARMAPPA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 N STATE ROAD 7
MARGATE FL
33063-5727
US

IV. Provider business mailing address

1525 W CYPRESS CREEK RD
FORT LAUDERDALE FL
33309
US

V. Phone/Fax

Practice location:
  • Phone: 954-974-0400
  • Fax: 954-978-4024
Mailing address:
  • Phone: 954-939-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME128939
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: