Provider Demographics
NPI:1669978953
Name:HAJEER, AMER
Entity type:Individual
Prefix:
First Name:AMER
Middle Name:
Last Name:HAJEER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11360 PORTOBELO DR UNIT 5
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-4025
Mailing Address - Country:US
Mailing Address - Phone:916-690-0095
Mailing Address - Fax:
Practice Address - Street 1:1507 BILL BECK BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-9516
Practice Address - Country:US
Practice Address - Phone:407-943-8600
Practice Address - Fax:407-564-2115
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01086548A208D00000X
CA390200000X
FLME158851208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115469800Medicaid