Provider Demographics
NPI:1679703631
Name:KAMI LALJI, D.P.M.,P.A.
Entity Type:Organization
Organization Name:KAMI LALJI, D.P.M.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:LALJI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:954-772-5380
Mailing Address - Street 1:2330 NE 53RD ST
Mailing Address - Street 2:
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-3212
Mailing Address - Country:US
Mailing Address - Phone:954-772-5380
Mailing Address - Fax:
Practice Address - Street 1:2330 NE 53RD ST
Practice Address - Street 2:
Practice Address - City:FT. LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3212
Practice Address - Country:US
Practice Address - Phone:954-772-5380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3249213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6316230001Medicare NSC