Healthcare Provider Details

I. General information

NPI: 1639798184
Provider Name (Legal Business Name): FARIS Z HAWATMEH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: FARIS ZIAD HAWATMEH DO

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 E 25TH ST
HIALEAH FL
33013-3402
US

IV. Provider business mailing address

840 E 25TH ST
HIALEAH FL
33013-3402
US

V. Phone/Fax

Practice location:
  • Phone: 786-882-5482
  • Fax: 305-402-4919
Mailing address:
  • Phone: 786-882-5482
  • Fax: 305-402-4919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberOS18246
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberOS18246
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberOS18246
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: