Basic Information
| Provider Information | |||||||||
| NPI: | 1851762108 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GHAFFARIPOUR | ||||||||
| FirstName: | TABAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4300 ALTON RD | ||||||||
| Address2: | PATHOLOGY | ||||||||
| City: | MIAMI BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331402948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056742277 | ||||||||
| FaxNumber: | 3056742999 | ||||||||
| Practice Location | |||||||||
| Address1: | 4300 ALTON RD | ||||||||
| Address2: | PATHOLOGY | ||||||||
| City: | MIAMI BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331402948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056742277 | ||||||||
| FaxNumber: | 3056742999 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2015 | ||||||||
| LastUpdateDate: | 10/13/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | TRN21983 | FL | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.