Provider Demographics
NPI:1063869709
Name:ALRAMLI, HAIDER
Entity type:Individual
Prefix:
First Name:HAIDER
Middle Name:
Last Name:ALRAMLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 US HIGHWAY 98 N UNIT 105
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-3863
Mailing Address - Country:US
Mailing Address - Phone:619-729-9579
Mailing Address - Fax:
Practice Address - Street 1:3700 US HIGHWAY 98 N UNIT 105
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-3863
Practice Address - Country:US
Practice Address - Phone:619-729-9579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100190122300000X
FL245331223P0300X
GA1232271223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist