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General NPI Number Information
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NPI Number | 1790160265
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Entity Type | Organization
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Legal Business Name | DAHDAH MEDICAL GROUP, INC
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 07/31/2015
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Provider Practice Location Address
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Address Line | 11760 BIRD RD SUITE 622A
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City | MIAMI
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State | FL
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Zip | 33175-3582
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Country | US
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Telephone | 786-427-3918
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Fax |
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Provider Business Mailing Address
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Address Line | 7993 NW 116TH AVE
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City | MEDLEY
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State | FL
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Zip | 33178-2533
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Country | US
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Telephone | 786-427-3918
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHELLE DAHDAH
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Credential |
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Telephone | 786-427-3918
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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 | ME108147
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License Number State | FL
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