MEDICARE: DR. RONALD HABAS M.D.

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	207P00000X	Emergency Medicine Physician	ME 75812	FL

General Provider Information

NPI Number	:	1336320803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD HABAS M.D.

Provider Business Mailing Address
First Line	:	2860 OAK TREE CT
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-6709
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2860 OAK TREE CT
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-6709
Country	:	US
Telephone Number	:	954-815-0090
Fax Number	:

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

Provider Enumeration Date	:	11/26/2007
Last Update Date	:	11/26/2007

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