Healthcare Provider Details

I. General information

NPI: 1447182290
Provider Name (Legal Business Name): DIABETES CARE & ENDOCRINOLOGY OF SOUTH FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2091 W ATLANTIC AVE APT 5505
DELRAY BEACH FL
33445-4805
US

IV. Provider business mailing address

2091 W ATLANTIC AVE APT 5505
DELRAY BEACH FL
33445-4805
US

V. Phone/Fax

Practice location:
  • Phone: 248-686-9622
  • Fax:
Mailing address:
  • Phone: 248-686-9622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SOUAD AL-BACHA
Title or Position: MD
Credential:
Phone: 248-686-9622