Provider Demographics
NPI:1386149060
Name:JIHAD ANDERSON, NAIMA KAI (DO)
Entity type:Individual
Prefix:
First Name:NAIMA
Middle Name:KAI
Last Name:JIHAD ANDERSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 NW 167TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5710
Mailing Address - Country:US
Mailing Address - Phone:954-800-4054
Mailing Address - Fax:954-654-7732
Practice Address - Street 1:1827 W HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1442
Practice Address - Country:US
Practice Address - Phone:954-800-4054
Practice Address - Fax:954-654-7732
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS17913207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine