Provider Demographics
NPI:1316234974
Name:POURPAKI, MARYAM (MD)
Entity type:Individual
Prefix:DR
First Name:MARYAM
Middle Name:
Last Name:POURPAKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2255 GLADES RD STE 228W
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7391
Mailing Address - Country:US
Mailing Address - Phone:561-320-0996
Mailing Address - Fax:
Practice Address - Street 1:4230 HARDING PIKE STE 301
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2098
Practice Address - Country:US
Practice Address - Phone:615-964-5823
Practice Address - Fax:615-577-1696
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN59857207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology