MEDICARE: GEORGE P BAHADUE MD, DO,

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1744R1102X	Research Study Specialist
2	207RH0003X	Hematology & Oncology Physician	ME02879821021	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	02879821021	OTHER	FL	AMA ME
2	B300-315-54-229-0	OTHER	FL	FLORIDA DRIVER LIC

General Provider Information

NPI Number	:	1508357625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE P BAHADUE MD, DO,

Provider Business Mailing Address
First Line	:	19665 E SAINT ANDREWS DR
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-2325
Country	:	US
Telephone Number	:	305-495-7560
Fax Number	:

Provider Business Practice Location Address
First Line	:	19665 E SAINT ANDREWS DR
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-2325
Country	:	US
Telephone Number	:	954-495-7560
Fax Number	:	305-495-7560

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2018
Last Update Date	:	01/12/2026

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