Provider Demographics
NPI:1083640353
Name:TABRAH, HALEH (MD)
Entity type:Individual
Prefix:
First Name:HALEH
Middle Name:
Last Name:TABRAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4240 5TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-2909
Mailing Address - Country:US
Mailing Address - Phone:305-814-5530
Mailing Address - Fax:
Practice Address - Street 1:4240 5TH AVE SW
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-2909
Practice Address - Country:US
Practice Address - Phone:305-814-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-461212084P0800X
OH35-07-9156-T2084P0800X
MO20220147692084P0800X
FLME769092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263053200Medicaid
FL263053200Medicaid
FL06461AMedicare ID - Type Unspecified