Healthcare Provider Details

I. General information

NPI: 1750499364
Provider Name (Legal Business Name): MERCEDES ABDUL-RUHMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6450 W 21ST CT SUITE 305
HIALEAH FL
33016-3946
US

IV. Provider business mailing address

6450 W 21ST CT SUITE 305
HIALEAH FL
33016-3946
US

V. Phone/Fax

Practice location:
  • Phone: 305-556-3671
  • Fax: 305-556-7740
Mailing address:
  • Phone: 305-556-3671
  • Fax: 305-556-7740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME43293
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: