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NPI Code Detail

MEDICARE: DR. IMAN DABIRI M.D.

MEDICARE: DR. IMAN DABIRI M.D.
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
12084N0400XNeurology Physician0101274392VA
2390200000XStudent in an Organized Health Care Education/Training Program
32084N0400XNeurology PhysicianME148392FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841721628
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IMAN DABIRI M.D.
Provider Business Mailing Address
First Line : 1875 NW 167TH AVE
Second Line :
City : PEMBROKE PNES
State : FL
Zip : 33028-2015
Country : US
Telephone Number : 954-937-0035
Fax Number :
Provider Business Practice Location Address
First Line : 4725 N FEDERAL HWY
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33308-4668
Country : US
Telephone Number : 954-414-9750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2017
Last Update Date : 04/20/2024

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