Provider Demographics
NPI:1346313194
Name:SOUTH MIAMI INPATIENT PHYSICIANS
Entity Type:Organization
Organization Name:SOUTH MIAMI INPATIENT PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GHASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HADDAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-662-5465
Mailing Address - Street 1:3441 3RD AVE SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34117-3019
Mailing Address - Country:US
Mailing Address - Phone:305-231-1204
Mailing Address - Fax:305-901-1482
Practice Address - Street 1:6200 SW 73RD ST
Practice Address - Street 2:BOX 69
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4679
Practice Address - Country:US
Practice Address - Phone:786-662-5465
Practice Address - Fax:786-662-5334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271302100Medicaid
FL74927Medicare ID - Type Unspecified