Provider Demographics
NPI:1760435226
Name:ABUKHALIL RASHID, NIDAL (MD)
Entity Type:Individual
Prefix:
First Name:NIDAL
Middle Name:
Last Name:ABUKHALIL RASHID
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:PO BOX 740
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-0740
Mailing Address - Country:US
Mailing Address - Phone:440-502-7171
Mailing Address - Fax:
Practice Address - Street 1:C20 CALLE SIMPLICIO DAVID
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-2217
Practice Address - Country:US
Practice Address - Phone:787-674-5580
Practice Address - Fax:787-754-1059
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR23024208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR22746Medicare ID - Type Unspecified