Healthcare Provider Details

I. General information

NPI: 1487966149
Provider Name (Legal Business Name): PAMELLA ABGHARI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2010
Last Update Date: 12/23/2019
Certification Date: 12/23/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7605 N STATE ROAD 7
PARKLAND FL
33073-3504
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 954-315-5780
  • Fax: 954-346-4182
Mailing address:
  • Phone: 954-315-5780
  • Fax: 954-346-4182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301096920
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number4301096920
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number35129059
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License NumberME134206
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: