Healthcare Provider Details

I. General information

NPI: 1306000211
Provider Name (Legal Business Name): KIPRIANOS S ARMENAKIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 05/25/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 BAY DR
POMPANO BEACH FL
33062-2912
US

IV. Provider business mailing address

1600 N FEDERAL HWY SUITE A
POMPANO BEACH FL
33062-3229
US

V. Phone/Fax

Practice location:
  • Phone: 754-888-5656
  • Fax:
Mailing address:
  • Phone: 754-234-0984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME107125
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME107125
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: