Basic Information
| Provider Information | |||||||||
| NPI: | 1831394709 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAREKH | ||||||||
| FirstName: | ANISH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15955 SW 96TH ST | ||||||||
| Address2: | SUITE 303 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331961271 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3053806773 | ||||||||
| FaxNumber: | 7865331680 | ||||||||
| Practice Location | |||||||||
| Address1: | 15955 SW 96TH ST | ||||||||
| Address2: | SUITE 303 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331961271 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3053806773 | ||||||||
| FaxNumber: | 7865331680 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2007 | ||||||||
| LastUpdateDate: | 11/20/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 233137 | MA | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | ME 112589 | FL | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
ID Information
| ID | Type | State | Issuer | Description | 1831394709 | 05 | FL | MEDICAID |