Healthcare Provider Details

I. General information

NPI: 1659510618
Provider Name (Legal Business Name): HARNEET KAUR WALIA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2009
Last Update Date: 01/06/2021
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 SW 87TH AVE STE 100
MIAMI FL
33173-5458
US

IV. Provider business mailing address

PO BOX 198054
ATLANTA GA
30384-8054
US

V. Phone/Fax

Practice location:
  • Phone: 786-204-4201
  • Fax:
Mailing address:
  • Phone: 786-204-4201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License NumberME147707
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: