| Doctor Name: | MR. IVAN ISLAMAJ |
| NPI Number: | 1174924963 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | PA9107915 |
| Business Practice Address: | 1160 Kane Concourse Suite 400 Bay Harbor Islands, FL - 331542053 |
| Business Phone Number: | 8882676362 |
| Business Fax Number: | 9544166118 |
| Mailing Address: | 1865 79th Street Cswy, Apt 11l NORTH BAY VILLAGE |
| State: | FL |
| Postal Code: | 331414238 |
| Phone Number: | 2165026577 |
| Fax Number: | |
| NPI Enumeration Date: | 09/11/2014 |
| NPI Last Update Date: | 09/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA9107915 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |