Provider Demographics
NPI:1275757205
Name:WAEL Z TAMIM M D P A
Entity Type:Organization
Organization Name:WAEL Z TAMIM M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WAEL
Authorized Official - Middle Name:Z
Authorized Official - Last Name:TAMIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-616-1916
Mailing Address - Street 1:PO BOX 350483
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33335-0483
Mailing Address - Country:US
Mailing Address - Phone:954-616-1916
Mailing Address - Fax:954-525-0808
Practice Address - Street 1:1625 SE 3RD AVE
Practice Address - Street 2:SUITE 723
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2521
Practice Address - Country:US
Practice Address - Phone:954-616-1916
Practice Address - Fax:954-525-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83922208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAF955Medicare PIN