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General NPI Number Information
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NPI Number | 1407877384
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Entity Type | Individual
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Provider Name | BABAK ALEX VAKILI MD
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Gender | Male
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2170 W STATE ROAD 434 STE 190
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City | LONGWOOD
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State | FL
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Zip | 32779-4976
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Country | US
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Telephone | 407-990-1921
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Fax | 407-990-1921
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Provider Business Mailing Address
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Address Line | 2170 W STATE ROAD 434 STE 190
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City | LONGWOOD
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State | FL
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Zip | 32779-4976
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Country | US
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Telephone | 407-990-1921
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Fax | 407-990-1921
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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 | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | ME84848
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License Number State | FL
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