Individual
HISHAM HADDAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3158 PRIMEBEEF WAY, DUKE FIELD, FL 32542
(850) 883-8162
Mailing address
3158 PRIMEBEEF WAY, DUKE FIELD, FL 32542
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29005393
MILITARY
TX
Enumeration date
01/08/2020
Last updated
09/13/2024
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