Healthcare Provider Details

I. General information

NPI: 1003600925
Provider Name (Legal Business Name): HADEEL DWEIK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 N FLAMINGO RD
PEMBROKE PINES FL
33028-1014
US

IV. Provider business mailing address

13231 NW 12TH ST
PEMBROKE PINES FL
33028-2707
US

V. Phone/Fax

Practice location:
  • Phone: 954-844-4491
  • Fax:
Mailing address:
  • Phone: 971-570-1665
  • 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: