Provider Demographics
NPI:1548611163
Name:AVICENNA SOLUTIONS LLC
Entity Type:Organization
Organization Name:AVICENNA SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL INVESTIGATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BEHNAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRGANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-290-3873
Mailing Address - Street 1:4602 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-5206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4602 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-5206
Practice Address - Country:US
Practice Address - Phone:954-491-4888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch