MEDICARE: MUHAMUD ABDUR-RAHIM LAC, AP

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
1	133N00000X	Nutritionist
2	171100000X	Acupuncturist	2232	FL

General Provider Information

NPI Number	:	1477001428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUHAMUD ABDUR-RAHIM LAC, AP

Provider Business Mailing Address
First Line	:	1115 SE 4TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-1119
Country	:	US
Telephone Number	:	786-222-9526
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 SE 4TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-1119
Country	:	US
Telephone Number	:	786-222-9526
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2016
Last Update Date	:	09/20/2016

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