Provider Demographics
NPI:1689037962
Name:EZALDEIN, HARIB H (MD)
Entity Type:Individual
Prefix:DR
First Name:HARIB
Middle Name:H
Last Name:EZALDEIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4770 BISCAYNE BLVD
Mailing Address - Street 2:STE 900
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3202
Mailing Address - Country:US
Mailing Address - Phone:786-664-7489
Mailing Address - Fax:786-550-1289
Practice Address - Street 1:4770 BISCAYNE BLVD
Practice Address - Street 2:STE 900
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3202
Practice Address - Country:US
Practice Address - Phone:786-664-7489
Practice Address - Fax:786-550-1289
Is Sole Proprietor?:No
Enumeration Date:2016-04-03
Last Update Date:2023-03-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME148896207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Single Specialty