Provider Demographics
NPI:1013404706
Name:FLORIDA MEDICAL PROFESSIONALS LLC
Entity Type:Organization
Organization Name:FLORIDA MEDICAL PROFESSIONALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TARIQ
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-601-7979
Mailing Address - Street 1:90 SW 3RD STREET 3001
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130
Mailing Address - Country:US
Mailing Address - Phone:561-601-7979
Mailing Address - Fax:561-855-6172
Practice Address - Street 1:ST. MARY'S MEDICAL CENTER 901 45TH STREET
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407
Practice Address - Country:US
Practice Address - Phone:561-601-7979
Practice Address - Fax:561-855-6172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty