Basic Information
| Provider Information | |||||||||
| NPI: | 1639519705 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALI | ||||||||
| FirstName: | AYESHA | ||||||||
| MiddleName: | SAJID | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1395 NW 167TH STREET | ||||||||
| Address2: | CHEN MED | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33169 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058314761 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8529 PINES BLVD | ||||||||
| Address2: | CHEN MEDICAL PEMBROKE PINES INC | ||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547043300 | ||||||||
| FaxNumber: | 9544317237 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2013 | ||||||||
| LastUpdateDate: | 08/11/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME126984 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.