Provider Demographics
NPI:1659564698
Name:GULF INTERNAL MEDICINE PL
Entity Type:Organization
Organization Name:GULF INTERNAL MEDICINE PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIDAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMAME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-861-0900
Mailing Address - Street 1:13740 OFFICE PARK CT
Mailing Address - Street 2:SUITE # F
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-7145
Mailing Address - Country:US
Mailing Address - Phone:727-861-0900
Mailing Address - Fax:727-861-5588
Practice Address - Street 1:13740 OFFICE PARK CT
Practice Address - Street 2:SUITE # F
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7145
Practice Address - Country:US
Practice Address - Phone:727-861-0900
Practice Address - Fax:727-861-5588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty