MEDICARE: HODA A MIKHAIL

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	208000000X	Pediatrics Physician	ME45309	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477668440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HODA A MIKHAIL

Provider Business Mailing Address
First Line	:	1100 S FEDERAL HWY
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-7035
Country	:	US
Telephone Number	:	954-418-0118
Fax Number	:	954-481-4460

Provider Business Practice Location Address
First Line	:	2100 E SAMPLE RD
Second Line	:	SUITE 101
City	:	LIGHTHOUSE POINT
State	:	FL
Zip	:	33064-7574
Country	:	US
Telephone Number	:	954-418-0118
Fax Number	:	954-481-4460

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	01/17/2014

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Directions to “ HODA A MIKHAIL ” Practice Location

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