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General NPI Number Information
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NPI Number | 1124068325
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Entity Type | Individual
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Provider Name | BOBAK REZA RAHMANIAN DO
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 13691 METRO PKWY STE 400
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City | FORT MYERS
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State | FL
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Zip | 33912-4349
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Country | US
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Telephone | 239-440-6456
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Fax | 239-236-0337
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Provider Business Mailing Address
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Address Line | PO BOX 9279
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City | JUPITER
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State | FL
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Zip | 33468-9279
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Country | US
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Telephone | 239-440-6456
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Fax | 239-236-0337
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DOS911
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | OS11406
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License Number State | FL
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