Provider Demographics
NPI:1114003191
Name:TOUFANIAN, AHMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:
Last Name:TOUFANIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 N. DIXIE HIGHWAY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401
Mailing Address - Country:US
Mailing Address - Phone:561-655-6800
Mailing Address - Fax:561-835-3686
Practice Address - Street 1:1500 N DIXIE HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2712
Practice Address - Country:US
Practice Address - Phone:561-655-6800
Practice Address - Fax:561-835-3686
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME35979174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL50956Medicare ID - Type Unspecified
FLD55918Medicare UPIN