Healthcare Provider Details

I. General information

NPI: 1265170252
Provider Name (Legal Business Name): RIMA HAJJAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date: 03/20/2023
Reactivation Date: 06/12/2023

III. Provider practice location address

1611 NW 12TH AVENUE SUITE 4070, HOLTZ CHILDRENS HOSPITAL
MIAMI FL
33136
US

IV. Provider business mailing address

1611 NW 12TH AVE STE 4070
MIAMI FL
33136-1005
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-3771
  • Fax: 305-325-1282
Mailing address:
  • Phone: 305-585-3771
  • Fax: 305-325-1282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number36157
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: