MEDICARE: DIMA MALAK JARAKI MD

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	207V00000X	Obstetrics & Gynecology Physician	V0769	TX

General Provider Information

NPI Number	:	1578192852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIMA MALAK JARAKI MD

Provider Business Mailing Address
First Line	:	8020 NW 167TH TER
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-3426
Country	:	US
Telephone Number	:	786-553-5438
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 UNIVERSITY BLVD
Second Line	:
City	:	GALVESTON
State	:	TX
Zip	:	77555-7201
Country	:	US
Telephone Number	:	409-747-2600
Fax Number	:

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

Provider Enumeration Date	:	04/07/2020
Last Update Date	:	09/26/2024

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