Healthcare Provider Details

I. General information

NPI: 1134902778
Provider Name (Legal Business Name): AGAM DHAWAN PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2023
Last Update Date: 10/07/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 W FLAGLER ST STE 300B #363
MIAMI FL
33130-1890
US

IV. Provider business mailing address

28 W FLAGLER ST STE 300B #363
MIAMI FL
33130-1890
US

V. Phone/Fax

Practice location:
  • Phone: 516-360-0849
  • Fax: 929-242-8093
Mailing address:
  • Phone: 516-360-0849
  • Fax: 929-242-8093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: AGAM DHAWAN
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 516-360-0849