Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | ME55102 | FL |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | ME55102 | FL |
NPI | 1790731719 |
---|---|
Provider Name | Dr. Mohammad Hajianpour |
First Address | Lauderdale Lakes, FL 33313-7260 |
Second Address | Lauderdale Lakes, FL 33313-7260 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 08/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
037590000 | (05) | FL |
E22891 | (02) | FL |