Provider Demographics
NPI:1912391384
Name:PASTEUR MEDICAL KENDALL
Entity Type:Organization
Organization Name:PASTEUR MEDICAL KENDALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:TARIK
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWATMEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-422-6821
Mailing Address - Street 1:9250 W FLAGLER ST STE 600
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3460
Mailing Address - Country:US
Mailing Address - Phone:786-422-6821
Mailing Address - Fax:
Practice Address - Street 1:14736 SW 88TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1481
Practice Address - Country:US
Practice Address - Phone:786-422-6821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty