MEDICARE: DR. REYAN AZAD GHANY MD, FACC, FASE, RPVI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME101246	FL
2	207RC0000X	Cardiovascular Disease Physician	ME101246	FL

General Provider Information

NPI Number	:	1043411150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REYAN AZAD GHANY MD, FACC, FASE, RPVI

Provider Business Mailing Address
First Line	:	1000 PARK CENTRE BLVD
Second Line	:	SUITE 100
City	:	MIAMI
State	:	FL
Zip	:	33169-5373
Country	:	US
Telephone Number	:	305-621-0023
Fax Number	:	305-623-9188

Provider Business Practice Location Address
First Line	:	1431 NE 162ND ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33161
Country	:	US
Telephone Number	:	305-949-0999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	09/24/2012

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