Provider Demographics
NPI:1134237720
Name:NEIMAND, DOUGLAS HOWARD (MD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:HOWARD
Last Name:NEIMAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8190 ROYAL PALM BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5706
Mailing Address - Country:US
Mailing Address - Phone:954-344-2288
Mailing Address - Fax:954-344-8443
Practice Address - Street 1:8190 ROYAL PALM BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5706
Practice Address - Country:US
Practice Address - Phone:954-344-2288
Practice Address - Fax:954-344-8443
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0039067207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D63073Medicare UPIN
93961YMedicare ID - Type Unspecified