Healthcare Provider Details

I. General information

NPI: 1518971753
Provider Name (Legal Business Name): BASSEM GEORGE CHAHINE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 11/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8740 N KENDALL DR SUITE # 215
MIAMI FL
33176-2212
US

IV. Provider business mailing address

8740 N KENDALL DR SUITE # 215
MIAMI FL
33176-2212
US

V. Phone/Fax

Practice location:
  • Phone: 305-270-1073
  • Fax: 866-982-8070
Mailing address:
  • Phone: 305-270-1073
  • Fax: 866-982-8070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberME98543
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: