Doctor Name: | ALI SHARIATI |
NPI Number: | 1407822240 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | ME79102 |
Business Practice Address: | 1600 Lakeland Hills Blvd Lakeland, FL - 33805 |
Business Phone Number: | 8636807000 |
Business Fax Number: | 8662648519 |
Mailing Address: | Po Box 95004, LAKELAND |
State: | FL |
Postal Code: | 33804 |
Phone Number: | 8636807206 |
Fax Number: | 8636807420 |
NPI Enumeration Date: | 02/23/2006 |
NPI Last Update Date: | 06/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | ME79102 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |