Provider Demographics
NPI:1285659995
Name:JARAKI, ABDUL-RAHMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDUL-RAHMAN
Middle Name:
Last Name:JARAKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8020 NW 167TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-3426
Mailing Address - Country:US
Mailing Address - Phone:305-654-7887
Mailing Address - Fax:305-654-1350
Practice Address - Street 1:7150 W 20TH AVE STE 318
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5532
Practice Address - Country:US
Practice Address - Phone:305-654-7887
Practice Address - Fax:305-654-1350
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55108207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056703500Medicaid
FLF08121Medicare UPIN
FL14282Medicare ID - Type Unspecified
FL14282ZMedicare PIN