Provider Demographics
NPI:1639798184
Name:HAWATMEH, FARIS Z (DO)
Entity Type:Individual
Prefix:DR
First Name:FARIS
Middle Name:Z
Last Name:HAWATMEH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:FARIS
Other - Middle Name:ZIAD
Other - Last Name:HAWATMEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:4300 ALTON RD STE 2065
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2948
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1565 W 29TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5516
Practice Address - Country:US
Practice Address - Phone:305-537-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLOS18246208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program