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General NPI Number Information
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NPI Number | 1952612996
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Entity Type | Individual
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Provider Name | VIKRAM V THAKAR DPM
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Gender | Male
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Dates
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Enumeration Date | 06/24/2010
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Last Update Date | 07/09/2012
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Provider Practice Location Address
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Address Line | 11302 SW 55 ST
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City | COOPER CITY
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State | FL
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Zip | 33330
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Country | US
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Telephone | 954-303-1779
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Fax |
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Provider Business Mailing Address
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Address Line | 11302 SW 55TH ST
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City | COOPER CITY
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State | FL
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Zip | 33330-4503
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Country | US
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Telephone | 954-303-1779
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO 3557
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License Number State | FL
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