Provider Demographics
NPI:1104849454
Name:ALHAMBRA PROFESSIONAL CENTER
Entity Type:Organization
Organization Name:ALHAMBRA PROFESSIONAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:YUSUF
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJABALEE
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:786-336-0095
Mailing Address - Street 1:8180 NW 36TH ST
Mailing Address - Street 2:ALHAMBRA PROFESSIONAL CENTER CORP SUITE 213
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166
Mailing Address - Country:US
Mailing Address - Phone:305-639-1773
Mailing Address - Fax:786-336-0097
Practice Address - Street 1:8180 NW 36TH ST
Practice Address - Street 2:ALHAMBRA PROFESSIONAL CENTER CORP SUITE 213
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166
Practice Address - Country:US
Practice Address - Phone:305-639-1773
Practice Address - Fax:786-336-0097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7157Medicare ID - Type Unspecified