Provider Demographics
NPI:1093843567
Name:VICTORIA E HAYDAR MD PA
Entity Type:Organization
Organization Name:VICTORIA E HAYDAR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAYDAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-251-3991
Mailing Address - Street 1:10251 SW 72ND ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2957
Mailing Address - Country:US
Mailing Address - Phone:305-279-1975
Mailing Address - Fax:305-274-9263
Practice Address - Street 1:10251 SW 72ND ST STE 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2957
Practice Address - Country:US
Practice Address - Phone:305-279-1975
Practice Address - Fax:305-274-9263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0045809207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty