Basic Information
| Provider Information | |||||||||
| NPI: | 1457493819 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SOBHAN | ||||||||
| FirstName: | FAUJIA | ||||||||
| MiddleName: | ZAMAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ZAMAN | ||||||||
| OtherFirstName: | FAUJIA | ||||||||
| OtherMiddleName: | AKHTAR | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1065 NE 125TH ST STE 409 | ||||||||
| Address2: | |||||||||
| City: | NORTH MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331615834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8888526672 | ||||||||
| FaxNumber: | 7862356225 | ||||||||
| Practice Location | |||||||||
| Address1: | 10301 HAGEN RANCH ROAD | ||||||||
| Address2: | B6 | ||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334373723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617529490 | ||||||||
| FaxNumber: | 5617529491 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2007 | ||||||||
| LastUpdateDate: | 09/08/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 22670 | NE | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | ME98237 | FL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 244578 | 01 | NE | MIDLANDS CHOICE | OTHER | D06244 | 01 | NE | BCBS | OTHER | 279814000 | 05 | FL | MEDICAID | AG589Z | 01 | FL | MEDICARE PTAN | OTHER | 47079687527 | 05 | NE | MEDICAID | 47079687531 | 05 | NE | MEDICAID |