Provider Demographics
NPI:1538597174
Name:VIKRAM THAKAR DPM PA
Entity type:Organization
Organization Name:VIKRAM THAKAR DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ORGANIZATION
Authorized Official - Prefix:DR
Authorized Official - First Name:VIKRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:THAKAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:954-303-1779
Mailing Address - Street 1:1440 BRICKELL BAY DR
Mailing Address - Street 2:APT 603
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3620
Mailing Address - Country:US
Mailing Address - Phone:954-303-1779
Mailing Address - Fax:
Practice Address - Street 1:1724 E HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4611
Practice Address - Country:US
Practice Address - Phone:954-454-9091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 3557213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty