Provider Demographics
NPI:1639452022
Name:HABIB, ABDELAZIZ
Entity Type:Individual
Prefix:MR
First Name:ABDELAZIZ
Middle Name:
Last Name:HABIB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 EAST LUCY STREET
Mailing Address - Street 2:#135
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034
Mailing Address - Country:US
Mailing Address - Phone:305-245-5502
Mailing Address - Fax:
Practice Address - Street 1:103 E LUCY ST
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-2501
Practice Address - Country:US
Practice Address - Phone:305-245-5502
Practice Address - Fax:305-245-5594
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA62433111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor