MEDICARE: ALI ABBAS HARAKE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME69018	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	27667	OTHER	FL	BLUE CROSS AND BLUE SHIEL

General Provider Information

NPI Number	:	1154341535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALI ABBAS HARAKE MD

Provider Business Mailing Address
First Line	:	2021 E COMMERCIAL BLVD STE 205
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-3754
Country	:	US
Telephone Number	:	954-938-9949
Fax Number	:	954-938-9956

Provider Business Practice Location Address
First Line	:	2021 E COMMERCIAL BLVD STE 205
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-3754
Country	:	US
Telephone Number	:	954-938-9949
Fax Number	:	954-938-9956

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	07/21/2023

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