Provider Demographics
NPI:1669666020
Name:ABRAHAM BICHACHI, M D
Entity Type:Organization
Organization Name:ABRAHAM BICHACHI, M D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BICHACHI
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:305-531-5559
Mailing Address - Street 1:4302 ALTON RD STE 420
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2849
Mailing Address - Country:US
Mailing Address - Phone:305-531-5559
Mailing Address - Fax:305-531-7821
Practice Address - Street 1:4302 ALTON RD
Practice Address - Street 2:SUITE 610
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2891
Practice Address - Country:US
Practice Address - Phone:305-531-5559
Practice Address - Fax:305-531-7821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258789100Medicaid
FL258789100Medicaid