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NPI Code Detail

MEDICARE: TAMARA IBRAHIMOVA SLP

MEDICARE: TAMARA IBRAHIMOVA SLP
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
1235Z00000XSpeech-Language Pathologist025490-1NY

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 : 1871941062
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMARA IBRAHIMOVA SLP
Provider Business Mailing Address
First Line : 22340 CALIBRE CT APT 404
Second Line :
City : BOCA RATON
State : FL
Zip : 33433-5571
Country : US
Telephone Number : 917-558-6915
Fax Number :
Provider Business Practice Location Address
First Line : 1955 N FEDERAL HWY UNIT 253
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33062-1036
Country : US
Telephone Number : 954-580-2520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2016
Last Update Date : 01/05/2022

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Directions to “ TAMARA IBRAHIMOVA SLP” Practice Location

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