Individual
DAVITA MABOURAKH HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6455 W COMMERCIAL BLVD, TAMARAC, FL 33319-2110
(549) 720-1414
(954) 720-4727
Mailing address
6455 W COMMERCIAL BLVD, TAMARAC, FL 33319-2110
(954) 720-1414
(954) 720-4727
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA11140800
NJ
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME153182
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
RTL22-0632
NC
Other
Enumeration date
04/04/2018
Last updated
07/15/2025
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