Provider Demographics
NPI:1144640624
Name:RAHAMAN, MALIKA (MD)
Entity type:Individual
Prefix:
First Name:MALIKA
Middle Name:
Last Name:RAHAMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15794 NW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2406
Mailing Address - Country:US
Mailing Address - Phone:561-601-6071
Mailing Address - Fax:
Practice Address - Street 1:1815 GRIFFIN RD STE 410
Practice Address - Street 2:
Practice Address - City:DANIA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33004
Practice Address - Country:US
Practice Address - Phone:954-624-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME131154207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine