Provider Demographics
NPI:1457493819
Name:SOBHAN, FAUJIA ZAMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:FAUJIA
Middle Name:ZAMAN
Last Name:SOBHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FAUJIA
Other - Middle Name:AKHTAR
Other - Last Name:ZAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1065 NE 125TH ST STE 409
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5834
Mailing Address - Country:US
Mailing Address - Phone:888-852-6672
Mailing Address - Fax:786-235-6225
Practice Address - Street 1:10301 HAGEN RANCH ROAD
Practice Address - Street 2:B6
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3723
Practice Address - Country:US
Practice Address - Phone:561-752-9490
Practice Address - Fax:561-752-9491
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE226702084P0800X
FLME982372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE244578OtherMIDLANDS CHOICE
NED06244OtherBCBS
FL279814000Medicaid
FLAG589ZOtherMEDICARE PTAN
NE47079687527Medicaid
NE47079687531Medicaid
FLAG589ZOtherMEDICARE PTAN
I10048Medicare UPIN