Provider Demographics
NPI:1477854727
Name:RAHAMAN, PETUELA F (AUD)
Entity Type:Individual
Prefix:DR
First Name:PETUELA
Middle Name:F
Last Name:RAHAMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4483 LUXEMBURG CT APT 304
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-5147
Mailing Address - Country:US
Mailing Address - Phone:561-344-3038
Mailing Address - Fax:
Practice Address - Street 1:5333 N DIXIE HWY STE 105
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3449
Practice Address - Country:US
Practice Address - Phone:954-417-3108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2075237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter