Healthcare Provider Details
I. General information
NPI: 1346313194
Provider Name (Legal Business Name): SOUTH MIAMI INPATIENT PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/16/2006
Last Update Date: 02/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6200 SW 73RD ST BOX 69
SOUTH MIAMI FL
33143-4679
US
IV. Provider business mailing address
3441 3RD AVE SW
NAPLES FL
34117-3019
US
V. Phone/Fax
- Phone: 786-662-5465
- Fax: 786-662-5334
- Phone: 305-231-1204
- Fax: 305-901-1482
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GHASSAN
HADDAD
Title or Position: DIRECTOR
Credential: MD
Phone: 786-662-5465