| Organization Name: | DR. RAHAT FADERANI, DO, MPH, PA |
| NPI Number: | 1326307919 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAHAT FADERANI (DOCTOR, OWNER) |
| Mailing Address: | 5913 S Congress Ave Lake Worth |
| State: | FL US |
| Postal Code: | 334621303 |
| Phone Number: | 5615438888 |
| Fax Number: | 8886638123 |
| NPI Enumeration Date: | 05/16/2012 |
| NPI Last Update Date: | 05/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |