Healthcare Provider Details

I. General information

NPI: 1750340048
Provider Name (Legal Business Name): ABRAHAM BICHACHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 12/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4302 ALTON RD #610
MIAMI BEACH FL
33140
US

IV. Provider business mailing address

4302 ALTON RD #610
MIAMI BEACH FL
33140
US

V. Phone/Fax

Practice location:
  • Phone: 305-531-5559
  • Fax: 305-531-7821
Mailing address:
  • Phone: 305-531-5559
  • Fax: 305-531-7821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME37315
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberME37315
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: