Individual provider Active NPI

Malika Rahaman, M.D.

  • Family Medicine Physician
  • Dania Beach, FL
National Provider Identifier
1144640624
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME131154 Issued in FL
Practice address
1815 Griffin Rd Ste 410
Dania Beach, FL 33004
Phone
(954) 624-7900
NPI assigned
Apr 23, 2014
Last updated
Aug 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME131154 FL Primary

Addresses

Primary practice location

1815 Griffin Rd Ste 410
Dania Beach, FL 33004

Mailing address

15794 NW 24TH St
Pembroke Pines, FL 33028-2406
Phone (561) 601-6071

Other practice location 1

1900 10th Ave
Suite # 100
Columbus, GA 31901-3600
Phone (706) 571-1430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190218001763 FL Practitioner - Internal Medicine 5294057600 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME131154FLMDFamily Medicine Physician
007147GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Palliative Care Services, Inc. CurrentSince Jun 1, 2020 Accepting new patients
Seasons Hospice & Palliative Care of Broward Florida LLC Family Medicine PastSince Jul 15, 2018 Accepting new patients

Locations

3487 NW 30th St
Lauderdale Lakes, FL 33311
Phone (954) 641-4200

14875 NW 77th Ave
Ste 100
Miami Lakes, FL 33014
Phone (305) 351-7057

14875 NW 77th Ave
Ste 201
Miami Lakes, FL 33014
Phone (305) 351-7086

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1144640624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15794 NW 24TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282406",
            "telephone_number": "561-601-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 GRIFFIN RD STE 410",
            "city": "DANIA BEACH",
            "state": "FL",
            "postal_code": "33004",
            "telephone_number": "954-624-7900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 10th Ave",
            "address_2": "Suite # 100",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319013600",
            "country_code": "US",
            "telephone_number": "706-571-1430",
            "fax_number": "706-571-1604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAHAMAN",
        "first_name": "MALIKA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME131154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dania Beach, FL

Sources for this page

Verify at the official NPI Registry.