Healthcare Provider Details
I. General information
NPI: 1093645095
Provider Name (Legal Business Name): PAIRTU HEALTH MEDICAL GROUP EAST, P. C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
390 NE 191ST ST STE 8393
MIAMI FL
33179-3899
US
IV. Provider business mailing address
390 NE 191ST ST STE 8393
MIAMI FL
33179-3899
US
V. Phone/Fax
- Phone: 310-415-5817
- Fax:
- Phone: 310-415-5817
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ARIAN
RAZZAGHI
Title or Position: CEO
Credential:
Phone: 310-415-5817