=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326467580
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENIEL PARMAR M.D., PH.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/15/2014
-----------------------------------------------------
Last Update Date | 01/21/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 800 MEADOWS RD
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33486-2304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-654-2939
-----------------------------------------------------
Fax | 419-251-2698
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 800 MEADOWS RD
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33486-2304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-654-2939
-----------------------------------------------------
Fax | 561-955-5157
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | 35.129173
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | ME130878
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------