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General NPI Number Information
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NPI Number | 1750222022
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Entity Type | Individual
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Provider Name | NIYAZ IBRAGIMOV RN
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Gender |
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 2290 NW 2ND AVE STE 10
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City | BOCA RATON
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State | FL
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Zip | 33431-7476
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Country | US
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Telephone | 305-363-7755
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Fax | 305-306-3366
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Provider Business Mailing Address
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Address Line | 2841 N OAKLAND FOREST DR APT 201
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City | OAKLAND PARK
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State | FL
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Zip | 33309-6453
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Country | US
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Telephone | 954-774-4745
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN9657002
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License Number State | FL
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