Individual
ALI SEDAGHEH PAKRAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12953 PALMS WEST DR, SUITE 201, LOXAHATCHEE, FL 33470-4990
(561) 795-5130
(561) 795-4160
Mailing address
12953 PALMS WEST DR, SUITE 201, LOXAHATCHEE, FL 33470-4990
(561) 795-5130
(561) 795-4160
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2007015061
MO
207RG0100X
Gastroenterology Physician
Primary
ME113916
FL
Other
Enumeration date
11/18/2007
Last updated
07/10/2014
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