Provider Demographics
NPI:1457503302
Name:AZAM, SAFIR (MD)
Entity Type:Individual
Prefix:
First Name:SAFIR
Middle Name:
Last Name:AZAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 W. 41ST STREET
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3346
Mailing Address - Country:US
Mailing Address - Phone:305-434-2148
Mailing Address - Fax:786-292-0091
Practice Address - Street 1:960 W. 41ST STREET
Practice Address - Street 2:SUITE 106
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33140-3346
Practice Address - Country:US
Practice Address - Phone:305-434-2148
Practice Address - Fax:786-292-0091
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1024092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry