Healthcare Provider Details

I. General information

NPI: 1619952645
Provider Name (Legal Business Name): PAMELA LYNN GARJIAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 10/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 N KENDALL DR STE 306W
MIAMI FL
33176-2131
US

IV. Provider business mailing address

6910 SW 88TH ST 1ST FLOOR
MIAMI FL
33156-1551
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-9966
  • Fax: 305-595-0282
Mailing address:
  • Phone: 305-669-1115
  • Fax: 305-669-0787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME56711
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: