Individual
NEGAR NIKNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13330 USF LAUREL DR, TAMPA, FL 33612
(813) 974-2201
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME136418
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098900
—
FL
01
—
6JZMD
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/20/2014
Last updated
11/27/2018
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