Basic Information
| Provider Information | |||||||||
| NPI: | 1477725448 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOLEH | ||||||||
| FirstName: | TARICK | ||||||||
| MiddleName: | YUNES | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 515 WEKIVA COMMONS CIR | ||||||||
| Address2: | |||||||||
| City: | APOPKA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327123645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4074649516 | ||||||||
| FaxNumber: | 4074649519 | ||||||||
| Practice Location | |||||||||
| Address1: | 515 WEKIVA COMMONS CIR | ||||||||
| Address2: | |||||||||
| City: | APOPKA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327123645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4074649516 | ||||||||
| FaxNumber: | 4074649519 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2008 | ||||||||
| LastUpdateDate: | 06/08/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME 110450 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208M00000X | ME110450 | FL | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.