Healthcare Provider Details

I. General information

NPI: 1992098222
Provider Name (Legal Business Name): STEVEN E RAHMAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2011
Last Update Date: 11/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3319 STATE ROAD 7 STE 109
WELLINGTON FL
33449-8067
US

IV. Provider business mailing address

3319 STATE ROAD 7 STE 109
WELLINGTON FL
33449-8067
US

V. Phone/Fax

Practice location:
  • Phone: 561-798-5437
  • Fax: 561-798-7726
Mailing address:
  • Phone: 561-798-5437
  • Fax: 561-798-7726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN E RAHMAN
Title or Position: OWNER
Credential: M.D.
Phone: 561-798-5437