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NPI Code Detail

MEDICARE: DR. M RAHAT FADERANI D.O., M.P.H.

MEDICARE:  DR. M RAHAT  FADERANI  D.O., M.P.H.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice PhysicianOS10474FL

General Provider Information

NPI Number : 1124271010
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. M RAHAT FADERANI D.O., M.P.H.
Provider Business Mailing Address
First Line : 5913 S CONGRESS AVE
Second Line :
City : ATLANTIS
State : FL
Zip : 33462-1303
Country : US
Telephone Number : 561-543-8888
Fax Number : 888-663-8123
Provider Business Practice Location Address
First Line : 5913 S CONGRESS AVE
Second Line :
City : ATLANTIS
State : FL
Zip : 33462-1303
Country : US
Telephone Number : 561-965-4300
Fax Number : 561-965-4399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2008
Last Update Date : 01/13/2012

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Directions to “ DR. M RAHAT FADERANI D.O., M.P.H.” Practice Location

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