Provider Demographics
NPI:1154997252
Name:ABDELHALIM, MARIAM (PSR)
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:
Last Name:ABDELHALIM
Suffix:
Gender:F
Credentials:PSR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14740 HARTFORD RUN DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7821
Mailing Address - Country:US
Mailing Address - Phone:407-716-4744
Mailing Address - Fax:
Practice Address - Street 1:7550 FUTURES DR STE 104
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-9096
Practice Address - Country:US
Practice Address - Phone:407-730-7983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation