Provider Demographics
NPI:1649455601
Name:LALANI, AZIM AKBARALI (MD)
Entity type:Individual
Prefix:DR
First Name:AZIM
Middle Name:AKBARALI
Last Name:LALANI
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 1:2902 59TH ST W STE C
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-7021
Mailing Address - Country:US
Mailing Address - Phone:941-877-7000
Mailing Address - Fax:941-242-1440
Practice Address - Street 1:2902 59TH ST W STE C
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-7021
Practice Address - Country:US
Practice Address - Phone:941-877-7000
Practice Address - Fax:941-242-1440
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301085736207Q00000X, 390200000X
FLME 103943207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001160600Medicaid
FL145AYOtherBCBS FL
FLBZ217ZMedicare PIN
FL001160600Medicaid