Healthcare Provider Details

I. General information

NPI: 1427029891
Provider Name (Legal Business Name): BASIM ELHABASHY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 01/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W 68TH ST
HIALEAH FL
33016-1801
US

IV. Provider business mailing address

504 N REO ST
TAMPA FL
33609-1013
US

V. Phone/Fax

Practice location:
  • Phone: 305-827-2711
  • Fax: 305-827-2113
Mailing address:
  • Phone: 813-549-2134
  • Fax: 813-864-4436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME94356
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: