Provider Demographics
NPI:1760799050
Name:BIBAWY, JOHN NABIL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:NABIL
Last Name:BIBAWY
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 1:180 JFK DR STE 311
Mailing Address - Street 2:
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6641
Mailing Address - Country:US
Mailing Address - Phone:615-434-0353
Mailing Address - Fax:561-357-0869
Practice Address - Street 1:180 JFK DR STE 311
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6641
Practice Address - Country:US
Practice Address - Phone:561-434-0353
Practice Address - Fax:561-357-0869
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME116693207RC0001X
NY272186207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME116693OtherFLORIDA STATE LICENSE