MEDICARE: RAMI K GHURANI 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	2086S0122X	Plastic and Reconstructive Surgery Physician	ME89865	FL
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DN19966	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	42617	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1659571313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMI K GHURANI M.D.

Provider Business Mailing Address
First Line	:	3122 NEW YORK ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-4328
Country	:	US
Telephone Number	:	305-477-4575
Fax Number	:	775-822-2039

Provider Business Practice Location Address
First Line	:	51 SW 42ND AVE
Second Line	:	1ST FLOOR
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-1770
Country	:	US
Telephone Number	:	305-477-4575
Fax Number	:	775-822-2039

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

Provider Enumeration Date	:	07/20/2007
Last Update Date	:	10/04/2014

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