Provider Demographics
NPI:1407273758
Name:NADJAFI, RAMIN ROBERT (DPM)
Entity Type:Individual
Prefix:DR
First Name:RAMIN
Middle Name:ROBERT
Last Name:NADJAFI
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 1:114 PARK LAKE ST.
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3809
Mailing Address - Country:US
Mailing Address - Phone:407-423-9401
Mailing Address - Fax:407-203-4025
Practice Address - Street 1:114 PARK LAKE ST.
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3809
Practice Address - Country:US
Practice Address - Phone:407-423-9401
Practice Address - Fax:407-203-4025
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3643213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7594910001OtherMEDICARE NSC