Provider Demographics
NPI:1508322157
Name:PASTEUR MEDICAL MANAGEMENT, LLC
Entity Type:Organization
Organization Name:PASTEUR MEDICAL MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PRACTICE LEAD
Authorized Official - Prefix:
Authorized Official - First Name:TARIK
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWATMEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-546-1964
Mailing Address - Street 1:9250 W FLAGLER ST STE 600
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3460
Mailing Address - Country:US
Mailing Address - Phone:786-422-6821
Mailing Address - Fax:
Practice Address - Street 1:4440 W 16TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7821
Practice Address - Country:US
Practice Address - Phone:786-298-5036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PASTEUR MEDICAL MANAGEMENT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-19
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty