MEDICARE: DR. REZEQ F EL BATAINEH 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	207Q00000X	Family Medicine Physician	ME0070013	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	593373618	OTHER	FL	TAX IDENTIFICATION
2	28519	OTHER	FL	BCBS OF FL
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609802073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REZEQ F EL BATAINEH M.D.

Provider Business Mailing Address
First Line	:	2575 HUNTCLIFF LN
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4902
Country	:	US
Telephone Number	:	850-785-6272
Fax Number	:	850-785-8686

Provider Business Practice Location Address
First Line	:	2575 HUNTCLIFF LN
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4902
Country	:	US
Telephone Number	:	850-785-6272
Fax Number	:	850-785-8686

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

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	01/25/2015

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