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General NPI Number Information
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NPI Number | 1275630717
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Entity Type | Individual
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Provider Name | RIAZ RAHMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/19/2006
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 4103 S MAIN ST
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City | STAFFORD
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State | TX
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Zip | 77477-5305
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Country | US
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Telephone | 713-984-4546
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Fax |
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Provider Business Mailing Address
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Address Line | 646 HILLS BLVD
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City | PORT ORANGE
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State | FL
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Zip | 32127-2902
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Country | US
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Telephone |
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Fax |
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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 | ME72252
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME72252
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | K5186
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License Number State | TX
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