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General NPI Number Information
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NPI Number | 1447884309
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Entity Type | Organization
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Legal Business Name | DATA MEDICAL INC
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Dates
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Enumeration Date | 02/28/2020
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Last Update Date | 02/28/2020
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Provider Practice Location Address
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Address Line | 12989 SOUTHERN BLVD STE 104
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-9205
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Country | US
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Telephone | 561-891-9810
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Fax |
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Provider Business Mailing Address
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Address Line | 8996 ALEXANDRA CIR
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City | WELLINGTON
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State | FL
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Zip | 33414-6438
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Country | US
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Telephone | 561-891-9810
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | NADER ABDALLAH
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Credential | DO
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Telephone | 561-891-9810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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