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General NPI Number Information
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NPI Number | 1215958756
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Entity Type | Individual
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Provider Name | AIMEE POONEH VAFAIE MD
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Gender | Female
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 10/13/2023
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Provider Practice Location Address
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Address Line | 1000 MAR WALT DR
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-6708
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Country | US
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Telephone | 214-676-1531
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Fax |
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Provider Business Mailing Address
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Address Line | 1317 EDGEWATER DR UNIT 495
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City | ORLANDO
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State | FL
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Zip | 32804-6350
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Country | US
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Telephone | 214-676-1531
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | L9529
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME129495
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License Number State | FL
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