Basic Information
| Provider Information | |||||||||
| NPI: | 1992098222 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | STEVEN E RAHMAN | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | PEDIATRIC CONSULTANTS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3319 STATE ROAD 7 STE 109 | ||||||||
| Address2: | |||||||||
| City: | WELLINGTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334498067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617985437 | ||||||||
| FaxNumber: | 5617987726 | ||||||||
| Practice Location | |||||||||
| Address1: | 3319 STATE ROAD 7 STE 109 | ||||||||
| Address2: | |||||||||
| City: | WELLINGTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334498067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617985437 | ||||||||
| FaxNumber: | 5617987726 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2011 | ||||||||
| LastUpdateDate: | 11/25/2014 | ||||||||
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| AuthorizedOfficialLastName: | RAHMAN | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5617985437 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080A0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine |
No ID Information.