Provider Demographics
NPI:1992561716
Name:MD STAT HEALTH CENTERS, LLC
Entity type:Organization
Organization Name:MD STAT HEALTH CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BABAK
Authorized Official - Middle Name:
Authorized Official - Last Name:SADAATMAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-833-3022
Mailing Address - Street 1:20 10TH ST NW UNIT 1704
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3869
Mailing Address - Country:US
Mailing Address - Phone:917-833-3022
Mailing Address - Fax:
Practice Address - Street 1:2701 E ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-4941
Practice Address - Country:US
Practice Address - Phone:917-833-3022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care