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General NPI Number Information
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NPI Number | 1174886386
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Entity Type | Individual
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Provider Name | IBRAHIM IHSAN JABBOUR MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 06/21/2012
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 3375 BURNS RD STE 206
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4361
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Country | US
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Telephone | 561-799-9559
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Fax |
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Provider Business Mailing Address
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Address Line | 8806 SONOMA LAKE BLVD
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City | BOCA RATON
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State | FL
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Zip | 33434-4069
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Country | US
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Telephone | 561-454-9114
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | ME141027
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME141027
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License Number State | FL
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