Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | ME106332 | FL |
N | 207VG0400X | Gynecologist | 106332 | FL |
NPI | 1386842136 |
---|---|
Provider Name | Amir Shariati |
First Address | Coconut Creek, FL 33073-4395 |
Second Address | Coconut Creek, FL 33073-4395 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 09/02/2022 |