Provider Demographics
NPI:1326262874
Name:HABIB, PHILLIP JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:JAMES
Last Name:HABIB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5035 VIA DELRAY
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-1315
Mailing Address - Country:US
Mailing Address - Phone:561-637-0500
Mailing Address - Fax:561-637-0055
Practice Address - Street 1:5035 VIA DELRAY
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-1315
Practice Address - Country:US
Practice Address - Phone:561-637-0500
Practice Address - Fax:561-637-0055
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115470207RA0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH57.011499Medicare UPIN