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NPI Code Detail

MEDICARE: DR WAFA ABDULRAZZAQ PA

MEDICARE: DR WAFA ABDULRAZZAQ PA
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
1305S00000XPoint of ServiceOPC3982FL

General Provider Information

NPI Number : 1932395274
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR WAFA ABDULRAZZAQ PA
Provider Business Mailing Address
First Line : 1411 NW 103RD AVE
Second Line :
City : PLANTATION
State : FL
Zip : 33322-6626
Country : US
Telephone Number : 954-646-3812
Fax Number :
Provider Business Practice Location Address
First Line : 8711 STIRLING RD
Second Line :
City : COOPER CITY
State : FL
Zip : 33328-5932
Country : US
Telephone Number : 954-434-1414
Fax Number : 954-434-1417
Authorized Official
Title or Position : DIRECTOR
Name : DR. WAFA ABDULRAZZAQ
Credential : O.D.
Telephone Number : 954-646-3812
Provider Enumeration Date : 09/20/2007
Last Update Date : 09/20/2007

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Directions to “DR WAFA ABDULRAZZAQ PA ” Practice Location

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