Healthcare Provider Details

I. General information

NPI: 1790313971
Provider Name (Legal Business Name): DESIREE BABIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 SHERIDAN ST
HOLLYWOOD FL
33021-3516
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 954-966-8000
  • Fax: 954-966-6614
Mailing address:
  • Phone: 954-967-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME163343
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: