Provider Demographics
NPI:1649651274
Name:NIKFARJAM, AKBAR (MD)
Entity type:Individual
Prefix:
First Name:AKBAR
Middle Name:
Last Name:NIKFARJAM
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 1:8750 NW 36TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2499
Mailing Address - Country:US
Mailing Address - Phone:305-262-1610
Mailing Address - Fax:
Practice Address - Street 1:7200 NW 7TH ST STE 150
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2941
Practice Address - Country:US
Practice Address - Phone:305-266-2929
Practice Address - Fax:305-266-9939
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-09
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN668208D00000X
FLME138986208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015160300Medicaid