Provider Demographics
NPI:1194736959
Name:ABDELMONEM, RAFAH (DDS)
Entity type:Individual
Prefix:
First Name:RAFAH
Middle Name:
Last Name:ABDELMONEM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 NW 167TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5133
Mailing Address - Country:US
Mailing Address - Phone:305-625-5400
Mailing Address - Fax:305-625-8110
Practice Address - Street 1:1505 NW 167TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-5133
Practice Address - Country:US
Practice Address - Phone:305-625-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16642122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist