Provider Demographics
NPI:1114746740
Name:EL RAHI, CHADI (MD)
Entity type:Individual
Prefix:
First Name:CHADI
Middle Name:
Last Name:EL RAHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16235 SW 304TH TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-4138
Mailing Address - Country:US
Mailing Address - Phone:904-314-2535
Mailing Address - Fax:
Practice Address - Street 1:1395 CALLE SAN RAFAEL
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2518
Practice Address - Country:US
Practice Address - Phone:787-999-7620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-09
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR002079-P.A.363A00000X
PR17456-I208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant