Provider Demographics
NPI:1962854653
Name:REHMAN, HIRA (OD)
Entity Type:Individual
Prefix:
First Name:HIRA
Middle Name:
Last Name:REHMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:HIRA
Other - Middle Name:REHMAN
Other - Last Name:JAAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:9060 SW 54TH PL
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-5852
Mailing Address - Country:US
Mailing Address - Phone:954-326-7972
Mailing Address - Fax:
Practice Address - Street 1:2840 NW FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-9253
Practice Address - Country:US
Practice Address - Phone:772-266-7751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 5243152W00000X
NYTUV008445152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist