Provider Demographics
NPI:1235372061
Name:AKHAVAN, ADRIAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:
Last Name:AKHAVAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 W 12TH AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5154
Mailing Address - Country:US
Mailing Address - Phone:305-558-0444
Mailing Address - Fax:305-557-3810
Practice Address - Street 1:7000 W 12TH AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5154
Practice Address - Country:US
Practice Address - Phone:305-558-0444
Practice Address - Fax:305-557-3810
Is Sole Proprietor?:No
Enumeration Date:2009-04-09
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO-3375213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery