Healthcare Provider Details

I. General information

NPI: 1619146909
Provider Name (Legal Business Name): TAHSEEN AKRAM RAWLS R.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. TAHSEEN AKRAM

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6925 LAKE ELLENOR DR SUITE 650
ORLANDO FL
32809-4631
US

IV. Provider business mailing address

4720 PARK EDEN CIR
ORLANDO FL
32810-1903
US

V. Phone/Fax

Practice location:
  • Phone: 407-852-1751
  • Fax: 407-852-1748
Mailing address:
  • Phone: 407-293-8275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND2813
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: