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General NPI Number Information
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NPI Number | 1154341535
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Entity Type | Individual
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Provider Name | ALI ABBAS HARAKE MD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | 2021 E COMMERCIAL BLVD STE 205
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-3754
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Country | US
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Telephone | 954-938-9949
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Fax | 954-938-9956
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Provider Business Mailing Address
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Address Line | 2021 E COMMERCIAL BLVD STE 205
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-3754
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Country | US
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Telephone | 954-938-9949
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Fax | 954-938-9956
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME69018
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License Number State | FL
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