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NPI Code Detail

MEDICARE: DR. JUSTIN ESAAM BABA MD

MEDICARE:  DR. JUSTIN ESAAM BABA  MD
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
1208000000XPediatrics Physician13436GA
2390200000XStudent in an Organized Health Care Education/Training Program
32080P0206XPediatric Gastroenterology Physician167067FL

General Provider Information

NPI Number : 1780261768
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUSTIN ESAAM BABA MD
Provider Business Mailing Address
First Line : 92 W MILLER ST
Second Line :
City : ORLANDO
State : FL
Zip : 32806-2036
Country : US
Telephone Number : 407-649-6876
Fax Number :
Provider Business Practice Location Address
First Line : 92 W MILLER ST
Second Line :
City : ORLANDO
State : FL
Zip : 32806-2036
Country : US
Telephone Number : 407-649-6876
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2021
Last Update Date : 05/15/2024

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Directions to “ DR. JUSTIN ESAAM BABA MD” Practice Location

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