Provider Demographics
NPI:1821134768
Name:DANESH, ALI ASGHAR (PHD, MS, BSC)
Entity Type:Individual
Prefix:DR
First Name:ALI ASGHAR
Middle Name:
Last Name:DANESH
Suffix:
Gender:M
Credentials:PHD, MS, BSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 NW 10TH AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1312
Mailing Address - Country:US
Mailing Address - Phone:561-807-7873
Mailing Address - Fax:561-807-7947
Practice Address - Street 1:1500 NW 10TH AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486
Practice Address - Country:US
Practice Address - Phone:561-807-7873
Practice Address - Fax:561-807-7947
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY953231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS2231AMedicare ID - Type Unspecified