Healthcare Provider Details

I. General information

NPI: 1407300437
Provider Name (Legal Business Name): REHAN NAQUI MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2016
Last Update Date: 08/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 NW 95TH ST
MIAMI FL
33150-2038
US

IV. Provider business mailing address

12618 S WINNERS CIR
DAVIE FL
33330-4332
US

V. Phone/Fax

Practice location:
  • Phone: 305-651-3033
  • Fax: 305-655-1153
Mailing address:
  • Phone: 305-651-3033
  • Fax: 305-655-1153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME85848
License Number StateFL

VIII. Authorized Official

Name: REHAN NAQUI
Title or Position: OWNER
Credential: MD
Phone: 305-651-3033