Organization Active NPI

Perwaiz Rahim MD PA

  • Pulmonary Disease Physician
  • Lakeland, FL
National Provider Identifier
1962627893
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
PERWAIZ RAHIM MD PA
Practice address
4712 Exploration Ave
Lakeland, FL 33812-3319
Phone
(863) 534-3707
Fax
(863) 534-3697
NPI assigned
Apr 16, 2007
Last updated
Jan 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Authorized official

Name
Perwaiz Hussain RahimNPI 1629053988
Title
Owner
Phone
(863) 534-3707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME82736 FL
Pulmonary Disease Physician 207RP1001X NU Primary
Sleep Medicine (Internal Medicine) Physician 207RS0012X NU

Addresses

Primary practice location

4712 Exploration Ave
Lakeland, FL 33812-3319

Mailing address

4712 Exploration Ave
Lakeland, FL 33812-3319
Phone (863) 534-3707

Other identifiers 1

IdentifierTypeStateIssuer
261855900MedicaidFL

Other names 1

  • Central Florida Sleep Diagnostic & Treatment Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041213000643 FL Part B Supplier - Clinic/Group Practice 3072570993 Receives reassigned benefits from 1 practitioner
Practice locations: Lakeland, FL

National Provider Directory

National Provider Directory

Locations

2200 Osprey Blvd
Ste 105
Bartow, FL 33830

2250 Osprey Blvd
Ste 105
Bartow, FL 33830
Phone (863) 519-9661

3651 Innovation Dr
Lakeland, FL 33812

3656 Innovation Dr
Lakeland, FL 33812
Phone (863) 534-3707

4712 Exploration Ave
Lakeland, FL 33812
Phone (863) 534-3707

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1962627893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 EXPLORATION AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338123319",
            "telephone_number": "863-534-3707",
            "fax_number": "863-534-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4712 EXPLORATION AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338123319",
            "telephone_number": "863-534-3707",
            "fax_number": "863-534-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERWAIZ RAHIM MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "RAHIM",
        "authorized_official_first_name": "PERWAIZ",
        "authorized_official_middle_name": "HUSSAIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-534-3707"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME82736",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261855900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Florida Sleep Diagnostic & Treatment Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Central Florida Sleep Diagnostic & Treatment Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.