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General NPI Number Information
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NPI Number | 1730454208
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Entity Type | Individual
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Provider Name | JASON MEHRABAN SAMII M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 03/17/2012
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Last Update Date | 09/28/2018
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Provider Practice Location Address
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Address Line | 8900 N KENDALL DR
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City | MIAMI
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State | FL
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Zip | 33176-2118
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Country | US
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Telephone | 786-596-1960
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Fax | 305-273-0254
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Provider Business Mailing Address
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Address Line | PO BOX 919336
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City | ORLANDO
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State | FL
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Zip | 32891-9336
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Country | US
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Telephone | 786-596-1960
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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 | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | 307847
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 307847
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME108428
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | 263610
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | ME 108428
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License Number State | FL
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