Healthcare Provider Details

I. General information

NPI: 1447452842
Provider Name (Legal Business Name): RABIH HABIB LOUTFI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 WALDEMERE ST STE 705
SARASOTA FL
34239-2913
US

IV. Provider business mailing address

1921 WALDEMERE ST SUITE 705
SARASOTA FL
34239-2943
US

V. Phone/Fax

Practice location:
  • Phone: 941-366-5864
  • Fax: 941-365-4276
Mailing address:
  • Phone: 941-366-5864
  • Fax: 941-365-4276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME101610
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberME 101610
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberM3303
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: