Healthcare Provider Details

I. General information

NPI: 1588573836
Provider Name (Legal Business Name): IBRAHIM ALI RAJAB RAJAB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 FAIRWAY DR
PALM BEACH GARDENS FL
33418-3701
US

IV. Provider business mailing address

7101 FAIRWAY DR
PALM BEACH GARDENS FL
33418-3701
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-6310
  • Fax:
Mailing address:
  • Phone: 305-243-6310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number46877
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: