Healthcare Provider Details

I. General information

NPI: 1700385309
Provider Name (Legal Business Name): HAWK MEDICAL CONSULTING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2018
Last Update Date: 11/15/2020
Certification Date: 11/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 NW 130TH TER
SUNRISE FL
33325-1349
US

IV. Provider business mailing address

301 YAMATO ROAD SUITE 1240
BOCA RATON FL
33431-4931
US

V. Phone/Fax

Practice location:
  • Phone: 305-349-3685
  • Fax: 305-995-0961
Mailing address:
  • Phone: 561-320-4355
  • Fax: 305-995-0961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ZAHIDUL HUQ
Title or Position: DIRECTOR
Credential: MD
Phone: 305-609-2376