Healthcare Provider Details

I. General information

NPI: 1962021006
Provider Name (Legal Business Name): SARA RAHAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 NW 9TH AVE STE 3100
MIAMI FL
33136-1409
US

IV. Provider business mailing address

4101 NW 89TH BLVD RM 1796
GAINESVILLE FL
32606-3813
US

V. Phone/Fax

Practice location:
  • Phone: 305-355-7000
  • Fax:
Mailing address:
  • Phone: 352-265-2863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberOS18698
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: