MEDICARE: MR. ADIB ANTOINE CHIDIAC M.D., P.A., FACOG

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	174400000X	Specialist	ME0043336	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932162682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ADIB ANTOINE CHIDIAC M.D., P.A., FACOG

Provider Business Mailing Address
First Line	:	PO BOX 50461
Second Line	:
City	:	LIGHTHOUSE POINT
State	:	FL
Zip	:	33074-0461
Country	:	US
Telephone Number	:	954-366-6039
Fax Number	:	954-366-6851

Provider Business Practice Location Address
First Line	:	1600 N FEDERAL HWY STE A
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-3229
Country	:	US
Telephone Number	:	954-366-6039
Fax Number	:	954-366-6851

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

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	09/27/2019

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