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General NPI Number Information
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NPI Number | 1912971086
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Entity Type | Individual
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Provider Name | HARISH D THAKER MD
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Gender | Male
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 1211 SE 2ND AVE
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City | FT LAUDERDALE
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State | FL
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Zip | 33316-1807
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Country | US
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Telephone | 954-524-6527
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Fax | 954-527-3732
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Provider Business Mailing Address
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Address Line | 1905 N RIVERSIDE DR
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City | POMPANO BEACH
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State | FL
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Zip | 33062-1221
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Country | US
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Telephone | 954-854-2951
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME23257
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME23527
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License Number State | FL
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