Provider Demographics
NPI:1730179672
Name:JAVID, SAFIEH (ARNP)
Entity type:Individual
Prefix:
First Name:SAFIEH
Middle Name:
Last Name:JAVID
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SAFIEH
Other - Middle Name:
Other - Last Name:JAVID
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8890 W OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7235
Mailing Address - Country:US
Mailing Address - Phone:954-742-3536
Mailing Address - Fax:954-742-3740
Practice Address - Street 1:8890 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7235
Practice Address - Country:US
Practice Address - Phone:954-742-3536
Practice Address - Fax:954-742-3740
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-23
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1563652363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL301919500Medicaid
FLR99386Medicare UPIN