Provider Demographics
NPI:1407834054
Name:PAMELA LYNN GARJIAN MDPA
Entity Type:Organization
Organization Name:PAMELA LYNN GARJIAN MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GARJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-669-1115
Mailing Address - Street 1:6910 SW 88TH ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-1551
Mailing Address - Country:US
Mailing Address - Phone:305-669-1115
Mailing Address - Fax:305-669-0787
Practice Address - Street 1:6910 SW 88TH ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-1551
Practice Address - Country:US
Practice Address - Phone:305-669-1115
Practice Address - Fax:305-669-0787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL09707OtherBLUE CROSS BLUE SHIELD
D73766Medicare UPIN
FLK7242Medicare ID - Type Unspecified