Healthcare Provider Details

I. General information

NPI: 1760284525
Provider Name (Legal Business Name): DR. ABDUL-AZIZ AL-KHAYYAT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12 AVENUE
MIAMI FL
33136
US

IV. Provider business mailing address

2350 SW 27TH AVENUE APT 1103
MIAMI FL
33145
US

V. Phone/Fax

Practice location:
  • Phone: 305-355-1122
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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: