MEDICARE: DR. MALAK EL-RAHI 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	207R00000X	Internal Medicine Physician	BP10032357	TX
2	207RN0300X	Nephrology Physician	ME13792	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME137992	OTHER	FL	LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962663070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MALAK EL-RAHI MD

Provider Business Mailing Address
First Line	:	5030 CHAMPION BLVD # G11110
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33496-2473
Country	:	US
Telephone Number	:	713-363-3000
Fax Number	:	713-791-1710

Provider Business Practice Location Address
First Line	:	5030 CHAMPION BLVD # G11110
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33496-2473
Country	:	US
Telephone Number	:	713-633-3000
Fax Number	:	713-791-1710

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

Provider Enumeration Date	:	06/20/2008
Last Update Date	:	10/21/2019

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