Provider Demographics
NPI:1700313806
Name:RAHMAN, SYED MUHAMMAD AFEEF (DO)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:MUHAMMAD AFEEF
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7599 CYPRESS GARDENS BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-3263
Mailing Address - Country:US
Mailing Address - Phone:863-324-4725
Mailing Address - Fax:863-229-7514
Practice Address - Street 1:7599 CYPRESS GARDENS BLVD
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-3263
Practice Address - Country:US
Practice Address - Phone:863-324-4725
Practice Address - Fax:863-324-4783
Is Sole Proprietor?:No
Enumeration Date:2017-05-19
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLOS16516207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107179900Medicaid