Provider Demographics
NPI:1891053096
Name:LATIF, EHAB (DPM)
Entity Type:Individual
Prefix:
First Name:EHAB
Middle Name:
Last Name:LATIF
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13137 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-2666
Mailing Address - Country:US
Mailing Address - Phone:201-680-9651
Mailing Address - Fax:
Practice Address - Street 1:13550 SW 88TH STREET
Practice Address - Street 2:SUITE 280
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1513
Practice Address - Country:US
Practice Address - Phone:954-398-0093
Practice Address - Fax:954-999-1282
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3543213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist