Provider Demographics
NPI:1629053988
Name:RAHIM, PERWAIZ HUSSAIN (MD)
Entity Type:Individual
Prefix:DR
First Name:PERWAIZ
Middle Name:HUSSAIN
Last Name:RAHIM
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 1:3656 INNOVATION DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33812-4105
Mailing Address - Country:US
Mailing Address - Phone:863-534-3707
Mailing Address - Fax:863-534-3697
Practice Address - Street 1:3656 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33812-4105
Practice Address - Country:US
Practice Address - Phone:863-534-3707
Practice Address - Fax:863-534-3697
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-09
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82736207RC0200X, 207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL223299OtherAMERIGROUP
FL261855900Medicaid
FL01797OtherBC/BS
FLP00210548OtherRAILROAD MEDICARE
FL223299OtherAMERIGROUP
FL01797YMedicare ID - Type Unspecified