MEDICARE: SAFIR AZAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	ME102409	FL

General Provider Information

NPI Number	:	1457503302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAFIR AZAM MD

Provider Business Mailing Address
First Line	:	960 W. 41ST STREET
Second Line	:	SUITE 106
City	:	MIAMI
State	:	FL
Zip	:	33140-3346
Country	:	US
Telephone Number	:	305-434-2148
Fax Number	:	786-292-0091

Provider Business Practice Location Address
First Line	:	960 W. 41ST STREET
Second Line	:	SUITE 106
City	:	MIAMI
State	:	FL
Zip	:	33140-3346
Country	:	US
Telephone Number	:	305-434-2148
Fax Number	:	786-292-0091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2008
Last Update Date	:	12/18/2014

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