Healthcare Provider Details

I. General information

NPI: 1003878208
Provider Name (Legal Business Name): PARVINE SADEGHI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62 AVENUE
MIAMI FL
33155
US

IV. Provider business mailing address

PO BOX 558750
MIAMI FL
33255-8750
US

V. Phone/Fax

Practice location:
  • Phone: 305-663-8409
  • Fax: 305-663-8573
Mailing address:
  • Phone: 305-663-8409
  • Fax: 305-663-8573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME79070
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: