Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DRPM2207 | FL |
NPI | 1043836562 |
---|---|
Provider Name | Syed Abdul-Rahman |
First Address | Gainesville, FL 32610-0416 |
Second Address | Gainesville, FL 32610-0416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2020 |
Last Update Date | 20/06/2020 |