Provider Demographics
NPI:1356733737
Name:IBRAHIM, HAMID KOI (DC)
Entity type:Individual
Prefix:
First Name:HAMID
Middle Name:KOI
Last Name:IBRAHIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10796 PINES BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3919
Mailing Address - Country:US
Mailing Address - Phone:954-367-4888
Mailing Address - Fax:954-367-4889
Practice Address - Street 1:10796 PINES BLVD STE 101
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3919
Practice Address - Country:US
Practice Address - Phone:954-367-4888
Practice Address - Fax:954-367-4889
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 11340111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation