Provider Demographics
NPI:1285829408
Name:MICHEL HABASHY, MD. P.A.
Entity Type:Organization
Organization Name:MICHEL HABASHY, MD. P.A.
Other - Org Name:DIABETES AND ENDOCRINOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:HABASHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-259-9970
Mailing Address - Street 1:918 ROLLING ACRES RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-5027
Mailing Address - Country:US
Mailing Address - Phone:352-259-9970
Mailing Address - Fax:352-259-9971
Practice Address - Street 1:918 ROLLING ACRES RD
Practice Address - Street 2:SUITE 6
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-5027
Practice Address - Country:US
Practice Address - Phone:352-259-9970
Practice Address - Fax:352-259-9971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL13198OtherBCBSFLORIDA
FL13198OtherBCBSFLORIDA
FLK3619Medicare PIN