Healthcare Provider Details

I. General information

NPI: 1962326959
Provider Name (Legal Business Name): RAHEEM REMTULLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 FAIRWAY DR
PALM BEACH GARDENS FL
33418-3701
US

IV. Provider business mailing address

1414 RUE CHOMEDEY 1254
MONTREAL QUEBEC
H3H 0A2
CA

V. Phone/Fax

Practice location:
  • Phone: 561-515-1500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number46803
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: