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General NPI Number Information
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NPI Number | 1881699858
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Entity Type | Individual
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Provider Name | AMJAD MUNIM MD
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 08/01/2014
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Provider Practice Location Address
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Address Line | 1820 E COMMERCIAL BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-3725
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Country | US
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Telephone | 954-771-7900
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Fax | 954-771-6863
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Provider Business Mailing Address
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Address Line | PO BOX 11527
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City | FORT LAUDERDALE
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State | FL
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Zip | 33339
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Country | US
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Telephone | 954-771-7900
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Fax | 954-771-6863
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | ME39847
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License Number State | FL
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