Healthcare Provider Details

I. General information

NPI: 1003803412
Provider Name (Legal Business Name): CHAKER MOHAMED DAHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CHAKER MOHAMED DAHAN MD

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13067 N TELECOM PKWY
TEMPLE TERRACE FL
33637-0926
US

IV. Provider business mailing address

7727 LAKE UNDERHILL RD
ORLANDO FL
32822-8224
US

V. Phone/Fax

Practice location:
  • Phone: 813-779-6303
  • Fax: 786-868-0012
Mailing address:
  • Phone: 407-821-3508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME74515
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD2026-0437
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number30723
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: