MEDICARE: JAMES GHATTAS 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	2084N0400X	Neurology Physician	THDO00018	AZ
2	208VP0014X	Interventional Pain Medicine Physician	OS18132	FL
3	2084N0400X	Neurology Physician	OS18132	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730537572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES GHATTAS DO

Provider Business Mailing Address
First Line	:	580 VILLAGE BLVD STE 270
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-1951
Country	:	US
Telephone Number	:	954-822-0543
Fax Number	:	954-836-7644

Provider Business Practice Location Address
First Line	:	580 VILLAGE BLVD STE 270
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-1951
Country	:	US
Telephone Number	:	954-822-0543
Fax Number	:	954-836-7644

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

Provider Enumeration Date	:	06/02/2016
Last Update Date	:	11/15/2024

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Directions to “ JAMES GHATTAS DO” Practice Location

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