Active NPI
Muazam Ghani Ikram
- Behavior Technician
- Stuart, FL
National Provider Identifier
1760110340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-218608
- Practice address
- 7108 S Kanner Hwy, Stuart, FL 324997
Stuart, FL 32499 - Phone
- (772) 349-6317
- NPI assigned
- Aug 11, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-22-218608 | FL | Primary |
Addresses
Primary practice location
7108 S Kanner Hwy, Stuart, FL 324997
Stuart, FL 32499
Mailing address
504 Timber LN
Panama City, FL 32405-4433
Phone (850) 774-7446
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-22-218608 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660176000000",
"number": "1760110340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 TIMBER LN",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324054433",
"telephone_number": "850-774-7446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7108 S KANNER HWY, STUART, FL 324997",
"city": "STUART",
"state": "FL",
"postal_code": "32499",
"telephone_number": "772-349-6317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IKRAM",
"first_name": "MUAZAM",
"middle_name": "GHANI",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-11",
"last_updated": "2022-08-11",
"certification_date": "2022-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-22-218608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stuart, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.