Provider Demographics
NPI:1477754109
Name:NOWBANDEGANI, BEHAM KARIMI (OTR)
Entity Type:Individual
Prefix:
First Name:BEHAM
Middle Name:KARIMI
Last Name:NOWBANDEGANI
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 E PINE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-6340
Mailing Address - Country:US
Mailing Address - Phone:407-895-0775
Mailing Address - Fax:
Practice Address - Street 1:5433 W STATE ROAD 46
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-9236
Practice Address - Country:US
Practice Address - Phone:407-324-7204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3956225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist